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Published on: November 12, 2015
Exposure keratopathy in prone ventilated patients: A cross-sectional study
Xiaomeng Han1, Jijun Qiao1, Fei Zheng1
1Department of Critical Care Medicine, the First Hospital of Lanzhou University, Lanzhou, Gansu, China; School of Nursing, Lanzhou University, Lanzhou, Gansu, China.
Objectives:
The objective of the study was to investigate the incidence of exposure keratopathy (EK) in prone position ventilation patients and to analyze the risk factors.
Methods:
We conducted a cross-sectional study in two ICUs located in two tertiary level hospitals. Medical records of patients receiving prone position ventilation between November 2022 and October 2024 were collected and their eye conditions were assessed using corneal fluorescein sodium ophthalmic test strips and cobalt blue light slit-lamp configuration. Univariate analysis and Logistic regression were used to analyze risk factors.
Results:
EK was observed in 129 of 252 patients (51.2 %). Richmond agitation-sedation scale (OR = 0.033 95 %CI: 0.004 ∼ 0.288), positive end-expiratory pressure (OR = 2.125 95 %CI: 1.443 ∼ 3.127), prone position ventilation time (OR = 2.537 95 %CI: 1.658 ∼ 3.881), frequency of prone position ventilation (OR = 7.147 95 %CI: 2.831 ∼ 18.041), eyelid insufficiency (OR = 7.643 95 %CI: 1.130 ∼ 51.709), ocular surface secretions (OR = 7.869 95 %CI: 1.855 ∼ 33.380) can increase the risk of EK.
Conclusions:
Clinical staff need to closely monitor prone position ventilation patients with high risk factors and take proactive preventive measures to reduce the risk of EK.
Implications For Clinical Practice:
The occurrence of EK in prone ventilation patients is closely related to the parameters of mechanical ventilation, depth of sedation and ocular conditions. Based on this finding, clinical staff should focus on observing these high-risk patients and give intervention measures to prevent the occurrence of EK as soon as possible.
