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

Methylene blue adsorption onto drinking water treatment plant’s sludge and modeling by artificial neural network

Bu çalışmada içme suyu arıtma tesislerinde arıtım aşamaları sonucu oluşan İçme Suyu Arıtma Tesisi Atık Çamurunun (İSATAÇ), atık sularda organik kökenli bir kirletici (boyar madde) olan Metilen Mavisinin uzaklaştırılmasında adsorban olarak kullanılabilirliği araştırılmıştır. Adsorpsiyon çalışmalarında kullanılan İSATAÇ fiziksel ya da kimyasal ön işleme tabi tutulmamıştır. Öncelikle İSATAÇ’ın nem, yoğunluk, uçucu madde, sabit karbon, kül tayini yanı sıra elementel, SEM, FT-IR, XRD, XRF ve TGA/DTA analiz gibi çeşitli analitik işlemlerle karakterize edilmiştir. Sonrasında adsorpsiyon deneyleri kesikli sistemle gerçekleştirilmiş ve İSATAÇ’ın sulu çözeltiden bu kirletici türü uzaklaştırma potansiyeli denge, kinetik ve termodinamik parametreler açısından incelenmiştir. Metilen mavisinin uzaklaştırılmasında Langmuir izoterm modelinden elde edilen maksimum adsorplama kapasitesi 62,50 mg g-1 olarak tespit edilmiştir. Bazı deneysel parametrelerin İSATAÇ üzerinde Metilen Mavisi adsorpsiyonuna etkileri göz önüne alınarak Yapay Sinir Ağı (YSA) modeli geliştirilmiş ve İSATAÇ’ın atık sulardan organik kirleticilerin uzaklaştırılmasında kullanılabileceği sonucuna varılmıştır.In this work, it was investigated usability of Drinking Water Treatment Sludge (DWTS), obtained as end product at the end of treatment stages, as an adsorbent for removal of Methylene Blue, the organic pollutant (dyestuff), present in wastewaters. DWTS used for the adsorption experiments were not subjected to physical or chemical pre-treatment. Firstly, DWTS was characterized employing various analytical procedures including determination of moisture, density, volatiles, fixed carbon, ash, as well as elemental, SEM, FT-IR, XRD, XRF and TGA/DTA analysis. Then, adsorption experiments were carried out in a batch system and DWTS’s removal potential of the pollutant specie from aqueous solution was investigated in terms of equilibrium, kinetics and thermodynamics. DWTS’s maximum adsorption capacity obtained from Langmuir model for Methylene Blue was 62.50 mg g-1. Artificial Neural Network (ANN) model was developed considering the effects of certain experimental parameters for adsorption of Methylene Blue on DWTS and it was concluded that DWTS can be used to remove organic pollutants from wastewaters

Removal of phenol from aqueous solutions by adsorption onto organomodified Tirebolu bentonite: Equilibrium, kinetic and thermodynamic study

A natural bentonite modified with a cationic surfactant, cetyl trimethylammonium bromide (CTAB), was used as an adsorbent for removal of phenol from aqueous solutions. The natural and modified bentonites (organobentonite) were characterized with some instrumental techniques (FTIR, XRD and SEM). Adsorption studies were performed in a batch system, and the effects of various experimental parameters such as solution pH, contact time, initial phenol concentration, organobentonite concentration, and temperature, etc. were evaluated upon the phenol adsorption onto organobentonite. Maximum phenol removal was observed at pH 9.0. Equilibrium was attained after contact of 1 h only. The adsorption isotherms were described by Langmuir and Freundlich isotherm models, and both model fitted well. The monolayer adsorption capacity of organobentonite was found to be 333 mg g(-1). Desorption of phenol from the loaded adsorbent was achieved by using 20% acetone solution. The kinetic studies indicated that the adsorption process was best described by the pseudosecond-order kinetics (R-2 > 0.99). Thermodynamic parameters including the Gibbs free energy (Delta G degrees), enthalpy (Delta H degrees), and entropy (Delta S degrees) were also calculated. These parameters indicated that adsorption of phenol onto organobentonite was feasible, spontaneous and exothermic in the temperature range of 0-40 degrees C. (C) 2009 Elsevier B.V. All rights reserved