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

Preliminary study of the mechanical and hygrothermal properties of hemp-magnesium phosphate cements

WOS:000369190800006International audienceThe use of bio-based materials in the construction field is of great interest to society and the scientific community because of its highly sustainable character. They are formed by plant fibres and a binder, usually cement, lime or pozzolanic additives. Among the new vegetable fibres used, hemp-based biomaterials have attracted great attention in the recent years due to its excellent thermal and hygroscopic properties. However, they present a very low mechanical performance, which has intensified the search for better alternatives. In this research, the use of magnesium phosphate cement (MPC) as binder with different hemp additions (8%, 12%, 16% and 20% by weight) was evaluated. Thus, a new material made of hemp and MPC (heMPC) was developed. According to the results obtained, the heMPC could be used in floor or pre-cast structural applications since it presented enhanced mechanical (sigma(max) = 0.714 +/- 0.11 MPa with a 20 wt.% of hemp content) and thermal (lambda(D) = 0.103 W . m(-1) . K-1, density = 600 kg . m(-3)) properties with respect other lime-based hemp biomaterials. Furthermore, the material exhibited good hygroscopic properties (water absorption by capillarity). Accordingly, this preliminary study allowed opening a new research line in the use of hemp bio-composites, in which other important properties are currently under investigation. The MPC used as a binder in this study was formulated with a by-product from the MgO industry, which increases the sustainability and recyclability criteria of the material developed. (C) 2015 Elsevier Ltd. All rights reserved

Biogas upgrading using MSWI bottom ash: an integrated municipal solid waste management

Biogas upgrading using bottom ash from the incineration of municipal solid waste (MSW) is especially interesting for integrated treatment facilities as it would allow closing a complete loop in MSW management. The aim of this research was to assess the interaction between bottom ash (BA) and biogas from anaerobic digestion with the outlook of upgrading in terms of CO and HS removal, with particle size and bottom ash aging as the main variables. The finest fraction of fresh bottom ash (FBA) presented the best performance, with a sorption capacity of 30-50kg CO·t dry FBA. The sorption capacity of weathered bottom ash (WBA) was lower than the recorded for the fresh material. From the results obtained it can be stated that the CO absorption capacity of bottom ash mainly relies in the finest fraction because of its larger surface area and higher CaO content. In what respect to HS sorption capacity, WBA presented a better performance, with values ranging 3.1-5.2kg HS and t dry WBA. In addition to the energetic enhancement, the proposed technology also allows an immediate stabilization and reuse of bottom ash as the leaching of heavy metals and metalloids remained under regulatory limits

Association of the FTO gene SNP rs17817449 with body fat distribution in Mexican women

Polymorphisms in the FTO gene are associated with obesity, body mass index, hip circumference, and visceral and subcutaneous fat area. The objective of this study was to analyze the association of the FTO rs17817449 genetic variant (T>G polymorphism) with body fat distribution patterns in women. We included 65 women and 71 healthy subjects in this study. Anthropometric parameters were determined and laboratory studies were performed. The polymorphism was detected by a PCR-RFLP method. The groups were categorized by type of body fat distribution: gynoid (N = 29) and android (N = 36). We found that the FTO gene polymorphism was not associated with body fat distribution according to the type of obesity (P > 0.05). The contribution of G and T alleles among groups indicated no statistically significant differences between the reference and gynoid group [P = 0.93; odds ratio (OR) = 0.97; 95% confidence interval (CI) = 0.46-2.02] and the reference and android group (P = 0.56; OR = 1.20; 95%CI = 0.54-2.82). Thorax circumference and thorax breast circumference were significantly different between the two groups (P = 0.009 and 0.021, respectively) with the genotype TT. We conclude that the FTO rs17817449 TT genotype predisposes individuals to fat deposition in the thoracic and breast region; individuals carrying this genotype had a decrease in thoracic and breast dimensions indirectly causing the gynoid phenotype in Mexican women. Zapotitlán FUNPEC-RP