[Application of an adjustable facial support pad in prone mechanical ventilation]

To improve the oxygenation dysfunction in critically ill patients undergoing mechanical ventilation, prone position ventilation has been increasingly adopted. However, it may cause patient discomfort, pressure injuries, facial edema, hemodynamic disturbances, and airway-related complications. To address these issues, the medical staff in the department of critical care medicine at Harrison International Peace Hospital Affiliated to Hebei Medical University, designed an adjustable facial support cushion for prone position ventilation, which has obtained a national utility model patent of China (patent number: ZL 2022 2 3295294.4). This device consists of an extendable support frame, a placement platform, a support platform, a forehead support cushion, bilateral cheek support cushions, a jaw and neck support cushion, an adjustment assembly, and a hook assembly. Patients who received prone position mechanical ventilation in the department of critical care medicine at Harrison International Peace Hospital Affiliated to Hebei Medical University from January 2022 to June 2024 were selected. They were divided into odd-numbered and even-numbered groups according to the order of prone positioning: the odd-numbered group served as the control group and the even-numbered group as the observation group, with 50 cases in each group. The control group used a soft pillow to support the face, while the observation group used a self-made adjustable facial support cushion. General characteristics, incidence of facial pressure injuries, and endotracheal tube displacement were compared between the two groups. Results showed that there were no statistically significant differences in gender, age, or primary diseases between the two groups, making them comparable. The incidence of facial pressure injuries in the observation group was significantly lower than that in the control group [18% (9/50) vs. 68% (34/50), P < 0.05]. Due to the support holes for the endotracheal tube and the hook assembly beneath the support platform of the cushion, the ventilator tubing was prevented from pulling the endotracheal tube by gravity, and thus the incidence of endotracheal tube displacement was significantly lower in the observation group [44% (22/50) vs. 96% (48/50), P < 0.05]. The use of the self-made adjustable facial support cushion can significantly reduce the occurrence of adverse events such as pressure injuries in patients undergoing prone position mechanical ventilation and is worthy of clinical promotion and application.