Noninvasive Ventilation Device-Related Pressure Injury in a Children's Hospital.

Area of Science:

• Pediatric critical care medicine
• Patient safety research
• Respiratory support technologies

Background:

• Noninvasive ventilation (NIV) is frequently associated with pressure injuries in hospitalized patients.
• Pressure injuries lead to prolonged hospital stays, increased pain, infection risk, and disfigurement.
• Understanding the link between NIV use and pressure injuries is crucial for patient care.

Purpose of the Study:

• To investigate the relationship between noninvasive ventilation (NIV) use and the incidence and severity of pressure injuries in hospitalized children.
• To identify specific characteristics of NIV use that correlate with pressure injury development.

Main Methods:

• Retrospective review of pediatric patients receiving NIV at a tertiary care children's hospital over a two-year period.
• Analysis of patient demographics, NIV usage characteristics (e.g., mask leak, pressure settings, duration), and pressure injury occurrence.
• Statistical analysis including univariate and multivariable models to determine significant risk factors.

Main Results:

• A total of 255 subjects and 343 NIV episodes were analyzed; 7.2% were associated with pressure injuries.
• Univariate analysis indicated associations between pressure injury and older age, maximum leak, 95th percentile leak, duration on NIV, and maximum inspiratory pressure.
• Multivariable analysis confirmed that high mask leak was the only statistically significant factor associated with pressure injury development.

Conclusions:

• High mask leak during noninvasive ventilation is a significant predictor of pressure injury development in hospitalized children.
• Identifying mask leak as a key risk factor can guide the implementation of targeted preventive strategies.
• This research supports the development of protocols to mitigate NIV-related hospital-acquired pressure injuries in pediatric populations.