Mekanik Ventilatördeki Hastalarda Basınç Yarası İnsidansı: Prospektif Bir Çalışma

Amaç: Bu çalışmanın amacı mekanik ventilatördeki hastalarda basınç yarası insidansını belirlemektir.Gereç ve Yöntem: Araştırmanın tipi kesitsel tipte prospektiftir. Batı Karadeniz Bölgesinde yer alan bir Devlet Hastanesinin 5 yoğun bakım ünitesinde yürütülmüştür. Araştırmanın örneklemini mekanik ventilasyon desteği başlatılan 260 hasta oluşturmuştur. Braden Risk Değerlendirme Ölçek puanı ile hastalardaki basınç yarası oluşma riski mekanik ventilasyon desteği başladıktan sonra 10. saat, 1. hafta ve 2. hafta zaman dilimlerinde değerlendirilmiştir. İstatistiksel analizlerde sayı, yüzde, ortalama, t testi, Anova ve Pearson Korelasyon analizi kullanılmıştır.Bulgular: Hastaların yaş ortalaması 54±10 yaş; %52.7’si erkek; %55.4’ünün Beden Kütle İndeksleri normal aralıktadır. Hastaların %46.5’inde serebrovasküler olay tanısı ile yatış yapıldığı; %52.3’ünün bilinç durumunun konfüze olduğu ve Braden Risk Değerlendirme Ölçek puanının 11.0±2.64 şeklinde yüksek risk grubunda olduğu belirlenmiştir. Kadın cinsiyette, bilinç durumu stupor olan hastalarda ve motor yanıtı dokunma ile çekme tepkisi veren hastalarda basınç yarası riski anlamlı olarak daha yüksektir. Mekanik ventilasyon tedavisi başlatıldıktan sonraki 10. saatte basınç yarası insidansının %10.8; birinci haftada %58.5; ikinci haftada %71.15 olduğu görülmüştür. İkinci haftanın sonunda hastaların %30’unda sakrum, %22.7’sinde koksik bölgesinde Evre 1 basınç yarası gelişmiştir. Sonuç: Mekanik ventilasyon tedavisi alan hastalarda ventilatörle ilişkili olarak basınç yarası gelişme insidansının oldukça yüksek olduğu sonucu ortaya çıkmıştır. Mekanik ventilatör ve diğer faktörlerin de etkisi göz önünde tutularak basınç yarasını önleme konusunda primer koruma önlemlerinin alınması oldukça önemlidir.

Anahtar Kelimeler:

Mekanik ventilasyon, Basınç yarası, Yoğun bakım

Incidence of Pressure Ulcers In The Patients On Mechanical Ventilation: A Prospective Study

Aim: The aim of this study was to determine the incidence of pressure ulcers among the patients on mechanical ventilation.Methods: The type of the study was cross-sectional and prospective. It was carried out in 5 intensive care units of a state hospital located in Western Black Sea region of Turkey. The sample of the study included 260 patients who began to get mechanical ventilatory support. Pressure ulcer risk in patients was assessed by Braden Risk Assessment Scale at 10th hour, 1st week and 2nd week timepoints following the initiation of mechanical ventilatory support. Results: Mean age of the patients was 54±10 years; 52.7% were males; and 55.4% had a Body Mass Index within normal range. It was determined that 46.5% of the patients were hospitalized due to the diagnosis of a cerebrovascular event; the state of consciousness was confused in 52.3% and mean Braden Risk Assessment Scale was 11.0±2.64. It was observed that the incidence of pressure ulcers was 10.8% at 10th hour, 58.5% at first week and 71.15% at second week following the beginning of mechanical ventilation treatment. At the end of second week, stage1 pressure ulcer was developed on the sacrum in 30% and on coccyx area in 22.7% of the patients. Conclusion:It was found that the incidence of pressure ulcer development risk was significantly high among the patients who underwent mechanical ventilation treatment. Considering the effect of mechanical ventilator and other factors, taking primary protective precautions for preventing pressure ulcers was suggested to be very important.

Keywords:

Mechanical ventilation, Pressure ulcer, Intensive care,

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