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Pressure ulcers in critically ill patients - Preventable by non-sedation? A substudy of the NONSEDA-trial
Helene K Nedergaard1, Trine Haberlandt2, Palle Toft3
1Department of Intensive Care, Lillebaelt Hospital, Kolding, Denmark; Institute for Clinical Research, University of Southern Denmark, Denmark.
Objective:
Pressure ulcers still pose a significant clinical challenge to critically ill patients. This study is a substudy of the multicenter NONSEDA-trial, where critically ill patients were randomised to sedation or non-sedation during mechanical ventilation. The objective of this substudy was to assess if non-sedation affected the occurrence of pressure ulcers.
Design:
Retrospective assessment of data from a single NONSEDA-trial site.
Setting:
Mixed intensive care unit.
Outcome Measures:
The occurrence of pressure ulcers, described by grade and location.
Results:
205 patients were included. Patients with pressure ulcers in the two groups were comparable with regards to baseline data. There were 44 ulcers in 32 patients in the sedated group and 31 ulcers in 25 patients in the non-sedated group (p=0.08). 64% of the ulcers in sedated patients were located on sacrum and heels, whereas 68% of the ulcers in non-sedated patients were related to equipment (p=0.03).
Conclusions:
Non-sedation did not significantly reduce the number of pressure ulcers. Non-sedation significantly affected the location of ulcers: non-sedated patients mainly had ulcers related to equipment, whereas sedated patients mainly had ulcers on the sacrum and heels.
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