Tissue interface pressure and skin integrity in critically ill, mechanically ventilated patients

Area of Science:

• Critical care medicine
• Biomedical engineering
• Dermatology

Background:

• Critically ill patients often require mechanical ventilation, increasing risk of pressure-related injuries.
• Understanding tissue interface pressure is crucial for preventing adverse skin outcomes in intensive care units (ICUs).

Purpose of the Study:

• To quantify tissue interface pressure and duration above critical thresholds.
• To assess the impact of these pressures on skin integrity in seven anatomical locations.

Main Methods:

• A descriptive, longitudinal study involving critically ill, mechanically ventilated adults.
• Continuous tissue interface pressure measurement using the XSENSOR system.
• Twice-daily skin integrity assessments using the National Pressure Ulcer Advisory Panel staging system.

Main Results:

• 90.9% of subjects showed no skin integrity changes.
• Maximum interface pressure exceeded 32mmHg nearly 100% of the time for the sacrum and trochanters.
• Left and right trochanters spent over 95% of the time above 45mmHg, followed by the sacrum.

Conclusions:

• High tissue interface pressures were prevalent, especially over the sacrum, despite minimal documented skin integrity changes.
• Maximum pressures may represent transient spikes, but sustained periods above critical levels are significant.
• Further investigation into the relationship between prolonged critical pressure exposure and skin integrity is warranted.