Related Experiment Video
Updated: Mar 15, 2026
06:51
Mouse Model of Pressure Ulcers After Spinal Cord Injury
Published on: March 9, 2019
10.2K
Risk Factors for the Development of Pressure Injury in the Heel Area in Critically Ill Patients
Anna Surmacz1,2, Izabela Sałacińska2, Maria Kózka3
1Specialist Hospital, Podkarpackie Oncology Center of Fr. B. Markiewicz in Brzozów, 36-200 Brzozów, Poland.
Journal of Clinical Medicine
|March 14, 2026
Summary
Critically ill patients with heel pressure injuries face increased risks from catecholamine infusions and poor distal perfusion, indicated by low ankle-brachial index (ABI) and creatinine levels. These factors significantly elevate the likelihood of developing these severe injuries.
Area of Science:
- Critical care medicine
- Wound healing research
- Patient safety protocols
Background:
- Hospital-acquired pressure injuries, particularly on heels, are a significant global issue for critically ill patients.
- Risk factors include comorbidities, circulatory dysfunction, organ failure, medications, and immobility.
- These factors impair microperfusion, leading to tissue hypoxia and damage.
Purpose of the Study:
- To investigate the impact of various risk factors on the development of heel pressure injuries in intensive care unit (ICU) patients.
- To identify specific clinical and biochemical markers associated with increased risk.
Main Methods:
- A prospective observational study involving 120 ICU patients.
- Initial risk assessment using the Braden scale and ankle-brachial index (ABI) within 24 hours of admission.
- Follow-up assessments between 5-10 days, including biochemical markers (CRP, creatinine) and perfusion evaluation.
- Statistical analysis using IBM SPSS Statistics v. 21.
Main Results:
- Catecholamine infusion (p < 0.001) and low ankle-brachial index (ABI-PAD) (p = 0.026) significantly correlate with heel pressure injury risk.
- Peripheral artery disease (PAD), indicated by low ABI, increases heel pressure injury likelihood by approximately fivefold (OR = 5.10).
- Elevated CRP (p = 0.016) and low creatinine levels (OR = 8.75, p = 0.033) are strongly associated with pressure ulcer development.
Conclusions:
- Distal perfusion disorders and circulatory failure are key contributors to pressure ulcer development in critically ill patients.
- Catecholamine use for circulatory support elevates the risk of heel pressure injuries.
- Pharmacotherapy and invasive procedures may increase pressure ulcer risk, irrespective of prevention efforts.
Related Concept Videos
01:26Peripheral Artery Disease IV: Nursing Management
528
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
528
01:30Venous Thrombosis IV: Nursing Management
354
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
354
01:23Peripheral Artery Disease V: Postoperative Nursing Management
506
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
506
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
580
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
580
01:26Varicose Veins I: Introduction
298
Varicose veins, or varicosities, are abnormally dilated and twisted superficial veins caused by venous valve incompetence. This condition commonly affects the lower extremities, especially the saphenous veins, due to the higher pressure from prolonged standing and walking. However, varicosities can also occur in other areas, such as the esophagus, vulva, spermatic cords, and anorectal region.Etiology and typesPrimary varicose veins, often idiopathic, are more common in women due to inherent...
298
01:11Assessing Blood pressure in the Leg
13.4K
Proper measurement of leg blood pressure is a critical skill for healthcare providers, ensuring precise and reliable readings. When performed correctly, this procedure informs patient care and enhances the efficacy of interventions. The following text outlines step-by-step guidelines to measure blood pressure in the leg, providing clarity and ease of understanding for practitioners.
Preparation:
Preparation:
13.4K