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Risk for corneal injury in intensive care unit patients: A cohort study
Rosimeire Silva Carneiro E Silva1, Fernanda Raphael Escobar Gimenes2, Natalia Pimentel Moreno Mantilla3
1Federal University of Acre, Multiprofessional Residency Program in Intensive Care Unit, Rio Branco, Acre, Brazil.
Aim:
To identify the incidence and risk factors for corneal injury amongst critically ill patients.
Method:
A prospective cohort study with adult patients from one intensive care unit in Northern Brazil. Logistic regression was performed to predict the risk factors associated with corneal injury.
Results:
Data from 149 patients revealed 18.8% (28/149) corneal injuries. Factors independently associated with corneal injury were patients with eyeball exposure (OR: 27.31; 95% CI: 3.50-212.78); lagophthalmos (OR: 17.15; 95% CI: 5.78-50.85); chemosis (OR: 7.39; 95% CI: 2.28-23.97), periorbital oedema (OR: 7.99; 95% CI: 2.19-29.13) and hospitalisation >7-days (OR: 11.96; 95% CI: 3.27-43.66) had a significantly higher risk of developing corneal injury in this ICU.
Conclusion:
Corneal injury was a common complication amongst critically ill patients and was associated with altered physiological function of the eyes such as exposure, lagophthalmos, chemosis and periorbital oedema. This study suggests introduction of a corneal injury prevention protocol for nursing and adding lagophthalmos and chemosis to the NANDA-I Taxonomy, thus contributing to the assessment and monitoring for the risk for corneal injury in critically ill patients.
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