A randomised controlled study of the efficacy of hypromellose and Lacri-Lube combination versus polyethylene/Cling wrap to prevent corneal epithelial breakdown in the semiconscious intensive care patient

Koroloff, Natasha; Boots, Robert; Lipman, Jeffrey; Thomas, Peter D. G.; Rickard, Claire M; Coyer, Fiona

doi:10.1007/s00134-004-2203-y

Cited by 81 publications

(109 citation statements)

References 20 publications

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“…Eight of thirty "lubricating eye drop" patients demonstrated corneal staining with fluorescein, which signified EK, contrasted with only 1 of 30 moisture chamber patients [43]. Koroloff et al [44] studied 110 ICU patients with reduced or absent blink reflex. Groups either received hypromellose drops and Lacrilube every 2 h or had polyethylene covers on the eyes to create a "moisture chamber."…”

Section: Treatmentmentioning

confidence: 99%

“…Eyes in both patient groups were cleaned every 2 h with saline. The study showed that none of the patients developed corneal ulceration in the polyethylene group while four patients experienced ulceration in the hypromellose group [44]. In another report, 146 patients were assigned to receive treatment with either a "moisture chamber" created with swimming goggles and gauze soaked in sterile water (closed chamber), or ocular lubricants with securing tape over the eyes (open chamber).…”

Section: Treatmentmentioning

confidence: 99%

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Exposure Keratopathy in the Intensive Care Unit: Do Not Neglect the Unseen

Bird¹,

Dingley²,

Stawicki³

et al. 2018

Vignettes in Patient Safety - Volume 2

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Exposure keratopathy (EK) is a frequently overlooked complication seen in nearly 60% of sedated or intubated intensive care unit (ICU) patients. Signs and symptoms of EK often start as mild subjective complaints of eye pain and irritation, but can progress to vision loss in the most severe cases. For many critically ill patients, the presence of sedation effectively precludes their ability to communicate clinical complaints typically associated with EK. This, combined with the potentially severe sequelae, makes EK a potentially preventable complication and a patient safety issue. Clinical management of EK can be challenging for both providers and patients due to the nature of treatment with eye drops and ointments as well as the burden and expense of associated procedural interventions. Risk factors for EK have been extensively described in the literature, and wider dissemination of this knowledge should facilitate education of physicians and nurses regarding EK prevention. The most common risk factors include lagophthalmos, chemosis, Bell's palsy, and congenital deformities. Additionally, critically ill patients are less likely to be promptly diagnosed due to the focus of staff on life-threatening problems over ocular prophylaxis. However, the potential severity of complications associated with EK mandates that prevention remains a crucial component of the care of at-risk patients. The reader will explore the broad category of adverse medical occurrences included under the umbrella term, "errors of omission" (EOO): an error category that is most likely to culminate in EK. The most critical preventive measure is education of health care providers, although this may not be enough by itself. To this end, universal precautions against EK in combination with education may be used to help combat the relatively high incidence of this easily preventable ocular pathology.

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Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Exposure Keratopathy in the Intensive Care Unit: Do Not Neglect the Unseen

Bird¹,

Dingley²,

Stawicki³

et al. 2018

Vignettes in Patient Safety - Volume 2

View full text Add to dashboard Cite

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“…It was found also that the reduced eyelid reflex at least five times per minute is an important risk factor associated with the prolonged use of sedatives and muscle relaxants that can lead to lagophthalmos with consequent prolonged eye opening that predisposes to dryness and corneal abrasion. [11][12] Other studies confirm these findings. 13,17 It was observed, so, that the muscular relaxation promoted by the action of neuromuscular blocking causes the decrease of the tonus of the eyelid which favors the incomplete closure.…”

Section: Turquiamentioning

confidence: 66%

Fatores de risco para lesão de córnea em pacientes criticos na terapia intensiva: uma revisão integrativa Risk factors for injury in the cornea in critical patients in intensive care: an integrative review

Oliveira¹,

Fernandes

Botarelli³

et al. 2016

R. pesq. cuid. fundam. online

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Oliveira RS, Fernandes APNL, Botarelli FR et al. Objective: summarizing the scientific content produced about the risk factors for corneal injury in critically ill patients in intensive care. Method: this is an integrative review of the literature conducted by question: "Which risk factors are involved in the development of corneal injury in critically ill patients in intensive care?" We searched the banks of BDENF, LILACS, SciELO and MEDLINE. The collection was performed according to the research protocol from January to April 2014. Results: the risk factors found are related to impairment of defense mechanisms, ventilation, and level of consciousness, severity and hemodynamic instability and use of specific medications. Conclusion: there was noted the scarcity of scientific papers about the subject in our country, which makes it imperative to urgent investigation into our reality, in order to demonstrate the problems of this disease. Descriptors: Corneal ulcer, Intensive care, Nursing.Objetivo: sumarizar o conteúdo científico produzido sobre os fatores de risco para lesão na córnea em pacientes críticos na terapia intensiva. Método: trata-se de uma revisão integrativa da literatura realizada através do questionamento: "Quais fatores de risco estão envolvidos no desenvolvimento da lesão na córnea em pacientes críticos na terapia intensiva?" Pesquisou-se nas bases de dados BDENF, LILACS, SciELO e MEDLINE. A coleta foi realizada segundo protocolo de pesquisa, de janeiro a abril de 2014. Resultados: os fatores de risco encontrados relacionam-se ao comprometimento dos mecanismos de defesa, assistência ventilatória, nível de consciência, gravidade e instabilidade hemodinâmica e uso de medicações específicas. Conclusão: constatou-se a escassez de produções científicas sobre a temática em nosso país, o que torna imperativo a urgente investigação em nossa realidade para demonstrar a problemática deste agravo. Descritores: Úlcera da córnea, Terapia intensiva, Enfermagem.Objetivo: resumir el contenido científico acerca de los factores de riesgo de lesión en la córnea en pacientes críticamente enfermos en cuidados intensivos. Método: se trata de una revisión integradora realizada por la pregunta: "¿Cuáles son los factores de riesgo que estean implicados en el desarrollo de la lesión en la córnea en pacientes críticamente enfermos en cuidados intensivos?" Se realizaron búsquedas en las orillas del BDENF, LILACS, SciELO y MEDLINE. Fue realizada en el período de enero a abril de 2014. Resultados: los factores de riesgo están relacionados con el deterioro de los mecanismos de defensa, ventilación, nivel de conciencia, la gravedad y la inestabilidad hemodinámica y el uso de determinados medicamentos. Conclusión: tomó nota de la escasez de trabajos científicos acerca del tema en nuestro país, lo que hace imperativo urgente investigación de nuestra realidad, con el fin de demostrar los problemas de esta enfermedad. Descriptores: Úlcera corneal, Cuidados intensivos, Enfermería. Patients with serious medical conditions are at high...

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“…Salienta-se que, em outros estudos (15,16) , o efeito do filme de polietileno também foi superior para a prevenção do olho seco, quando comparado ao uso do colírio lubrificante gotas associado à lágrima artificial em gel (p=0,12) (15) e à pomada ocular (p=0,519)…”

Section: Introductionunclassified

Efetividade Do Filme De Polietileno Na Prevenção De Olho Seco Em Pacientes Críticos: Revisão Sistemática

Araújo

Ribeiro

Chianca

2017

revenf

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Objetivo: identificar o efeito do filme de polietileno na prevenção de olho seco em pacientes críticos internados em unidade de terapia intensiva para adultos. Metodologia: estudo de revisão sistemática, guiada pelas recomendações do PRISMA. foram identificados 784 estudos primários, avaliados 35 e selecionados quatro, nos quais houve referência à utilização do filme de polietileno para a prevenção de olho seco. Observou-se discreta superioridade na efetividade do filme de polietileno em relação às demais intervenções. Conclusão: as evidências não foram suficientes para afirmar se a eficácia do filme de polietileno é superior às outras intervenções. Sugere-se realização de ensaio clínico randomizado para verificar a eficácia de diferentes intervenções de enfermagem na prevenção de olho seco em pacientes críticos.Descritores: Síndromes do Olho Seco, Unidades de Terapia Intensiva, Enfermagem. POLYETHYLENE FILM EFFECTIVENESS IN DRY EYE IN CRITICAL PATIENTS PREVENTION: SYSTEMATIC REVIEWObjective: To identify the effect of polyethylene film on the prevention of dry eye in critically ill patients admitted to an adult intensive care unit. Methodology: A systematic review study, guided by PRISMA recommendations. Seven databases were searched through strategies that involved the cross-referencing of Dry Eye Syndromes, Keratoconjunctivitis Sicca, Corneal Diseases, Risk Factors, Intensive Care Units, Hospital and Nursing. Results: A total of 784 primary studies were identified, 35 were evaluated and four were selected, with reference to the use of polyethylene film for the prevention of dry eye. There was a slight superiority in the effectiveness of the polyethylene film in relation to the other interventions. Conclusion: The evidence was not sufficient to establish whether the efficacy of the polyethylene film is superior to that of other interventions.We suggest performing a randomized clinical trial to verify the efficiency of different nursing interventions in the prevention of dry eye in critically ill patients.Descriptors: Dry Eye Syndromes, Intensive Care Units, Nursing. EFICACIA DE LA PELÍCULA DE POLIETILENO EN OJO SECO EN CRÍTICO PACIENTES PREVENCIÓN: REVISIÓN SISTEMÁTICAObjetivo: Identificar el efecto de película de polietileno para evitar que el ojo seco en pacientes en estado crítico en la unidad de cuidados intensivos para adultos. Metodologia: estudio de revisión sistemática, guiándose por las recomendaciones PRISMA.Se llevó a cabo la búsqueda en siete bases de datos a través de estrategias que implican el cruce de descriptores: Dry Eye síndromes, queratoconjuntivitis seca, enfermedades de la córnea, factores de riesgo, unidades de cuidados intensivos, del hospital y de enfermería. Resultados: Se encontraron 784 estudios primarios identificados, evaluados y seleccionados de cuatro 35 en la que se hizo referencia a la utilización de una película de polietileno para la prevención del ojo seco. Hubo una ligera superioridad en la eficacia de la película de polietileno en relación con otras intervenciones. Conclus...

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A randomised controlled study of the efficacy of hypromellose and Lacri-Lube combination versus polyethylene/Cling wrap to prevent corneal epithelial breakdown in the semiconscious intensive care patient

Abstract: Polyethylene covers are as effective as HL in reducing the incidence of corneal damage in intensive care patients.

Cited by 81 publications

References 20 publications

Exposure Keratopathy in the Intensive Care Unit: Do Not Neglect the Unseen

Exposure Keratopathy in the Intensive Care Unit: Do Not Neglect the Unseen

Fatores de risco para lesão de córnea em pacientes criticos na terapia intensiva: uma revisão integrativa Risk factors for injury in the cornea in critical patients in intensive care: an integrative review

Efetividade Do Filme De Polietileno Na Prevenção De Olho Seco Em Pacientes Críticos: Revisão Sistemática

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