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

Experimental Study and Percolation Analysis on Seepage Characteristics of Fractured Coal and Sandstone Based on Real-Time Micro-CT

Sandstone and coal are the two most common types of reservoirs in nature. The permeability of sandstone in oil-bearing formations controls its oil and gas production; the permeability of the coal seam containing gas has a crucial influence on the gas drainage efficiency. One of the main factors affecting rock permeability is the spatial distribution and connectivity of pores and fissures in the rock. In this paper, a small-sized sample with a diameter of 5 mm and a height of 10 mm was used for the test. The rock samples under different stress states were scanned in real-time during the seepage testing. Based on 2D images, a 3D digital sample was reconstructed. We extracted the pores and fissures from the 3D digital sample, studied the size and distribution of the largest cluster in the sample, and revealed the influence of confining pressure and seepage pressure on the percolation probability and permeability of the sample. The research results show that brittle sandstone and plastic coal, two types of rocks with completely different properties of mechanics, have obvious differences in the spatial distribution of the largest clusters. Under the same stress state, in brittle sandstone-like rocks, the connectivity of the fissures is the primary factor affecting permeability, and the pores are the auxiliary factor; for plastic rocks such as coal, the situation is just the opposite, pores are the primary factor affecting permeability, and fissures are the auxiliary factor. The research results answer the question: Hydraulic fracturing technology can increase the oil and gas production of sandstone reservoirs but cannot increase the drainage efficiency of coalbed methane

On the generation of magnetic field enhanced microwave plasma line

Microwave linear plasmas sustained by surface waves have attracted much attention due to the potential abilities to generate large-scale and uniform non-equilibrium plasmas. An external magnetic field was generally applied to enhance and stabilize plasma sources because the magnetic field decreased the electron losses on the wall. The effects of magnetic field on the generation and propagation mechanisms of the microwave plasma were tentatively investigated based on a 2-D numerical model combining a coupled system of Maxwell's equations and continuity equations. The mobility of electrons and effective electric conductivity of the plasma were considered as a full tensor in the presence of magnetic field. Numerical results indicate that both cases of magnetic field in the axial-direction and radial-direction benefit the generation of a high-density plasma; the former one allows the microwave to propagate longer in the axis direction compared to the latter one. The time-averaged power flow density and the amplitude of the electric field on the inner rod of coaxial waveguide attenuate with the propagation of the microwave for both cases of with and without external magnetic field. The attenuation becomes smaller in the presence of appropriately higher axial-direction magnetic field, which allows more microwave energies to transmit along the axial direction. Meanwhile, the anisotropic properties of the plasma, like electron mobility, in the presence of the magnetic field confine more charged particles in the direction of the magnetic field line. Published by AIP Publishing

On the Characteristics of Coaxial-Type Microwave Excited Linear Plasma: a Simple Numerical Analysis

To unveil the characteristics and available propagation mechanism of coaxial-type microwave excited line-shape plasma, the effects of parameters including microwave power, working pressure, dielectric constant, and external magnetic field on the plasma distribution were numerically investigated by solving a coupled system of Maxwell's equations and continuity equations. Numerical results indicate that high microwave power, relatively high working pressure, low dielectric constant, and shaped magnetic field profiles will help produce a high-density and uniform plasma source. Exciting both ends by microwave contributed to the high-density and uniform plasma source as well. Possible mechanisms were analyzed by using the polarization model of low temperature plasma. The generation and propagation processes of the line-shape plasma mainly depend on the interaction of three aspects, i.e. the transmitted part, penetration part and absorptive part of the electromagnetic field. The numerical results were qualitatively consistent with available experimental results from literature. More elaborate descriptions of the three aspects and corresponding interactions among them need to be investigated further to improve the properties of the line-shape plasma

Effect of different resumption strategies to flatten the potential COVID-19 outbreaks amid society reopens: a modeling study in China

Background: the effect of the COVID-19 outbreak has led policymakers around the world to attempt transmission control. However, lockdown and shutdown interventions have caused new social problems and designating policy resumption for infection control when reopening society remains a crucial issue. We investigated the effects of different resumption strategies on COVID-19 transmission using a modeling study setting.Methods: we employed a susceptible-exposed-infectious-removed model to simulate COVID-19 outbreaks under five reopening strategies based on China’s business resumption progress. The effect of each strategy was evaluated using the peak values of the epidemic curves vis-à-vis confirmed active cases and cumulative cases. Two-sample t-test was performed in order to affirm that the pick values in different scenarios are different.Results: we found that a hierarchy-based reopen strategy performed best when current epidemic prevention measures were maintained save for lockdown, reducing the peak number of active cases and cumulative cases by 50 and 44%, respectively. However, the modeled effect of each strategy decreased when the current intervention was lifted somewhat. Additional attention should be given to regions with significant numbers of migrants, as the potential risk of COVID-19 outbreaks amid society reopening is intrinsically high.Conclusions: business resumption strategies have the potential to eliminate COVID-19 outbreaks amid society reopening without special control measures. The proposed resumption strategies focused mainly on decreasing the number of imported exposure cases, guaranteeing medical support for epidemic control, or decreasing active cases