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Pressure Injuries Due to Prone Positioning in Patients with COVID-19

Betsy Todd

    The American Journal of Nursing
    |June 23, 2022
    PubMed

    Insights

    Preventing pressure injuries in COVID-19 patients on prone positioning requires preemptive interventions. Key risk factors include obesity, prolonged prone duration, male sex, high D-dimer levels, and specific endotracheal tube holders.

    Area of Science:

    • Critical Care Medicine
    • Patient Safety
    • Infectious Disease Epidemiology

    Background:

    • Patients with COVID-19 often require prone positioning to improve oxygenation.
    • Prone positioning can increase the risk of pressure injuries, impacting patient outcomes.
    • Identifying risk factors is crucial for developing preventative strategies.

    Purpose of the Study:

    • To identify risk factors associated with pressure injuries in COVID-19 patients undergoing prone positioning.
    • To inform the development of preemptive interventions to mitigate pressure injury development.

    Main Methods:

    • Retrospective analysis of COVID-19 patients receiving prone positioning.
    • Statistical analysis to determine correlations between patient characteristics and pressure injury development.
    • Evaluation of factors including body mass index, duration of prone therapy, and device usage.

    Main Results:

    • Severe obesity was identified as a significant risk factor for pressure injuries.
    • Prolonged duration of prone positioning correlated with increased injury risk.
    • Male sex, elevated D-dimer levels, and the use of commercial endotracheal tube holders were also associated with higher incidence.

    Conclusions:

    • Preemptive interventions are essential for preventing pressure injuries in mechanically ventilated COVID-19 patients in the prone position.
    • Targeted strategies should address identified risk factors like obesity and prolonged ventilation.
    • Further research into optimal positioning protocols and device selection is warranted.

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