Ophthalmology in Critical Care

Parekh, Priyanka; Boente, Charline S.; Boente, R.; Meeker, J.; Carlos, W. Graham

doi:10.1513/annalsats.201812-848cme

Cited by 10 publications

(8 citation statements)

References 77 publications

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“…Risk factors for the development of EK from this review include lagophthalmos, chemosis, eye blinks<5 times per minute, mechanical ventilation, sedation, lower GCS score and higher APACHE II score. The association of these factors has been reported in previous studies (Bird et al., 2018; Hearne et al., 2018; Parekh et al., 2019). However, a high APACHE II score has not been reported before.…”

Section: Discussionsupporting

confidence: 72%

“…EK is often iatrogenic but easy to observe and prevent in critically ill patients (Ghionni et al, 2017;Parekh et al, 2019), and its prevalence and incidence are indirect measures of the quality of care provided (Bird et al, 2018). However, the event rate was reported differently in different studies, ranging from 3.6% to 60% (Cho et al, 2017;Martínez-García et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and risk factors of exposure keratopathy among critically ill patients: A systematic review and meta‐analysis

Chen,

He,

et al. 2023

Nursing Open

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AimsTo identify the incidence, prevalence and risk factors of exposure keratopathy (EK) among critically ill patients.DesignSystematic review and meta‐analysis, in accordance with the PRISMA 2020 Statement.MethodsThe Cochrane Library, PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), China Knowledge Resource Integrated Database (CNKI), Chinese Biomedical Database (CBM), Weipu Database (VIP) and WanFang Database were systematically searched from inception to June 2022. Observational studies that reported EK among paediatric and adult critically ill patients were screened and included original articles based on the inclusion criteria. Two reviewers independently completed data extraction and quality assessments. Subgroup analysis investigated potential causes of heterogeneity.ResultsOf the 4508 studies identified, 23 studies involving 3519 subjects were included. The pooled prevalence of EK was 34.0%, and the pooled incidence rate of EK was 23.0%. Risk factors associated with EK in critically ill patients included lagophthalmos, chemosis, eye blinks <5 times per minute, mechanical ventilation, sedation, lower Glasgow Coma Scale (GCS) score and higher Acute Physiology and Chronic Health Evaluation (APACHE) II score.ConclusionThis review shows that EK rates are high in critically ill patients and are influenced by multiple factors. Medical staff should pay more attention to EK in critically ill patients, conduct professional evaluations and implement targeted eye care protocols to reduce its occurrence.Implications for PracticeThis study shows the frequency of and multiple risk factors for EK in critically ill patients, which provides evidence‐based guidance for nurses to evaluate the risk of EK in critically ill patients and take appropriate precautions to reduce the risk.Protocol RegistrationThe protocol was registered in PROSPERO (https://www.crd.york.ac.uk/prospero/) (CRD42022346964).Patient or Public ContributionNo patient or public contribution.

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Section: Discussionsupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Prevalence and risk factors of exposure keratopathy among critically ill patients: A systematic review and meta‐analysis

Chen,

He,

et al. 2023

Nursing Open

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“…Incidences of ocular surface disease and other ophthalmic complications in ICU patients are high, ranging from 20% to 60% of cases, depending on the diagnosis criteria, the number of hospitalization days, and other factors [3][4][5][6]22].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors of Eye Complications in Patients Treated in the Intensive Care Unit

Płaszewska‐Żywko

Sega

Bukowa

et al. 2021

IJERPH

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In critically ill patients, normal eye protection mechanisms, such as tear production, blinking, and keeping the eye closed, are impaired. In addition, many other factors related to patients’ severe condition and treatment contribute to ocular surface disease. Reducing risk factors and proper eye care can have a significant impact on incidences of eye complications and patient quality of life after discharge from the intensive care unit (ICU). The aim of the study was to determine risk factors for ocular complication, especially those related to nursing care. The study was conducted in the ICU of a university hospital. Methods for estimating and analyzing medical records were used. The patient’s evaluation sheet covering 12 categories of risk factors for eye complications was worked out. The study group included 76 patients (34 patients with injuries and 42 without injuries). The Shapiro–Wilk test, the Spearman’s rank correlation test, the Mann–Whitney U test and the Friedman’s ANOVA test were used. The level of significance was set at α = 0.05. The most important risk factors for eye complications in the study group were: lagophthalmos (p < 0.001), sedation (p < 0.01), use of some cardiological drugs and antibiotics (p < 0.01), mechanical ventilation (p < 0.05), use of an open suctioning system (p < 0.01), presence of injuries (p < 0.01) including craniofacial trauma (p < 0.001), high level of care intensity (p < 0.01), failure to follow eye care protocol (p < 0.001), length of hospitalization at the ICU (p < 0.001), and the frequency of ophthalmological consultations (p < 0.001). There was no correlation between the incidence of these complications and the age and gender of the patients. The exposure of critically ill patients to eye complications was high. It is necessary to disseminate protocols and guidelines for eye care in ICU patients to reduce the risk factors.

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“…Dėl kritinės būklės pacientų gynybos mechanizmų susilpnėjimo gali išsausėti ragena, atsirasti išopėjimas, perforacija, infekcija, susidaryti randų, o tai gali rimtai pakenkti regėjimo aštrumui ir gyvenimo kokybei. Konjunktyvitas, chemozė (junginės edema), lagoftalmas (patologinis nevisiškas vokų susiglaudimas), ragenos abrazija (paviršinis epitelio sužalojimas), ekspozicinė keratopatija (ragenos džiūvimas, sukeliantis epitelio sužalojimą), sausos akys ir endoftalmitas (uždegimas, pažeidžiantis akies obuolio vidų) yra pagrindinės akių komplikacijos ITS [2]. Šiame skyriuje akių priežiūra dažnai apleidžiama, nes medikai sutelkia savo veiksmus į kritinės būklės pacientų gyvybę palaikančias intervencijas.…”

Section: įVadasunclassified

“…Ekspozicinė keratopatija -patologija, kuri atsiranda išsausėjus ragenai dėl ilgo išorės poveikio, pvz., sutrikus mirksėjimui. P. Parekh ir bendraautorių [2] apžvalgoje teigiama, jog ši patologija labai dažna, netaikant reikiamos priežiūros, išsivysto 3,6-60 proc. ITS pacientų.…”

Section: Rezultatai Ir Jų Aptarimas Dažniausi Pažeidimai Ir Ligosunclassified

Akių Priežiūra Intensyviosios Terapijos Skyriuje

Kanapeckas¹,

Marčiulionytė²,

Vargalis³

2020

Health Sciences

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Mokslinėje literatūroje daugėja įrodymų, jog intensyviosios terapijos skyriuose (ITS) medikai, sutelkę veiksmus į gyvybę palaikančias intervencijas, apleidžia kritinės būklės pacientų akių priežiūrą. Šiuose skyriuose gydomi sunkios būklės pacientai, dažnai be sąmonės, jiems taikoma sedacija, todėl reikšmingai susilpnėja fiziologiniai akių apsauginiai mechanizmai (išnyksta mirksėjimo refleksas, nevisiškai užmerkiamos akys, sutrinka ašarų išsiskyrimas bei ašarų plėvelės funkcija) ir padidėja akių ligų rizika. Šiame darbe analizuojamos mokslinės publikacijos, kuriose aprašytos dažniausiai ITS nustatomos akių ligos ar būklės: ekspozicinė keratopatija, chemozė, mikroorganizmų sukelti keratitai ar konjunktyvitai. Rasta publikacijų apie akių priežiūrą, patologijų prevenciją. Apibendrinus rezultatus, padarytos išvados, jog akių pažeidimai ITS yra dažni, jų galima išvengti ar sumažinti riziką, pritaikius akių priežiūros protokolus. Dažniausiai patogenai patenka ant junginės ir ją kolonizuoja, atliekant intervencijas, kurių metu iš kvėpavimo takų išsiskiria aerozoliai. Įvertinus atliktus tyrimus, pastebėta, jog barjeriniai akių tvarsčiai iš polietileno laikomi efektyviausia prevencine priemone, siekiant išvengti akių paviršiaus pažeidimo, lyginant su įprastiniais metodais, kai akys užmerkiamos ir užklijuojamos pleistru. Rasta publikacijų, įrodančių, jog organizuojant ITS darbuotojų edukacijos programas, galima užtikrinti kokybišką akių priežiūrą ir išvengti dažniausių akių ligų pasireiškimo.

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Ophthalmology in Critical Care

Cited by 10 publications

References 77 publications

Prevalence and risk factors of exposure keratopathy among critically ill patients: A systematic review and meta‐analysis

Prevalence and risk factors of exposure keratopathy among critically ill patients: A systematic review and meta‐analysis

Risk Factors of Eye Complications in Patients Treated in the Intensive Care Unit

Akių Priežiūra Intensyviosios Terapijos Skyriuje

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