Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Multipactor in low pressure gas and in nonuniform rf field structures

Resonant electron multiplication in vacuum, multipactor, is analysed for several geometries where the RF electric field is nonuniform. In particular, it is shown that the multipactor behaviour in a coaxial line is both qualitatively and quantitatively different from that observed with the conventionally used simple parallel-plate model. Analytical estimates based on an approximate solution of the non-linear differential equation of motion for the multipacting electrons are supported by extensive particle-in-cell simulations. Furthermore, in a microwave iris the electrons tend to perform a random walk in the axial direction of the waveguide due to the initial velocity distribution. The effects of this phenomenon on the breakdown threshold are analysed. The study shows that the threshold is a function of the height-to-length ratio of the iris and for a fixed value of this ratio, the multipactor susceptibility charts can be generated in the classical engineering units. Using the parallelplate concept, the multipactor threshold in low pressure gases has been analysed using a model for the electron motion that takes into account three important effects of electron-neutral collisions, viz. the friction force, electron thermalisation, and impact ionisation. It is found thatall three effects play important roles, but the degree of influence depends on parameters such as order of resonance and secondary emission properties. In addition, a new method for detection of multipactor is presented. By applying a weak amplitude modulation to the input signal and performing a fast Fourier transform on the detected signal, accurateand unambiguous measurement results can be obtained. It is demonstrated how the method can be used in both single and multicarrier operation

Multipactor in low pressure gas and in nonuniform rf field structures

Resonant electron multiplication in vacuum, multipactor, is analysed for several geometries where the RF electric field is nonuniform. In particular, it is shown that the multipactor behaviour in a coaxial line is both qualitatively and quantitatively different from that observed with the conventionally used simple parallel-plate model. Analytical estimates based on an approximate solution of the non-linear differential equation of motion for the multipacting electrons are supported by extensive particle-in-cell simulations. Furthermore, in a microwave iris the electrons tend to perform a random walk in the axial direction of the waveguide due to the initial velocity distribution. The effects of this phenomenon on the breakdown threshold are analysed. The study shows that the threshold is a function of the height-to-length ratio of the iris and for a fixed value of this ratio, the multipactor susceptibility charts can be generated in the classical engineering units. Using the parallelplate concept, the multipactor threshold in low pressure gases has been analysed using a model for the electron motion that takes into account three important effects of electron-neutral collisions, viz. the friction force, electron thermalisation, and impact ionisation. It is found thatall three effects play important roles, but the degree of influence depends on parameters such as order of resonance and secondary emission properties. In addition, a new method for detection of multipactor is presented. By applying a weak amplitude modulation to the input signal and performing a fast Fourier transform on the detected signal, accurateand unambiguous measurement results can be obtained. It is demonstrated how the method can be used in both single and multicarrier operation