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Research ArticleOriginal Research

Treatment-Related Risk Factors for Development of Skin Breakdown in Patients With Acute Respiratory Failure Undergoing Noninvasive Ventilation or CPAP

Wellington P Yamaguti, Eliana V Moderno, Sandra Y Yamashita, Thelma GMC Gomes, Ana Lígia V Maida, Claudia S Kondo, Isabel CD de Salles and Christina MM de Brito
Respiratory Care June 2014, respcare.02942; DOI: https://doi.org/10.4187/respcare.02942
Wellington P Yamaguti
Rehabilitation Service, Physiotherapy Department, Hospital Sírio-Libanês, São Paulo, Brazil.
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  • For correspondence: [email protected] [email protected]
Eliana V Moderno
Rehabilitation Service, Physiotherapy Department, Hospital Sírio-Libanês, São Paulo, Brazil.
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Sandra Y Yamashita
Rehabilitation Service, Physiotherapy Department, Hospital Sírio-Libanês, São Paulo, Brazil.
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Thelma GMC Gomes
Rehabilitation Service, Physiotherapy Department, Hospital Sírio-Libanês, São Paulo, Brazil.
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Ana Lígia V Maida
Rehabilitation Service, Physiotherapy Department, Hospital Sírio-Libanês, São Paulo, Brazil.
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Claudia S Kondo
Rehabilitation Service, Physiotherapy Department, Hospital Sírio-Libanês, São Paulo, Brazil.
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Isabel CD de Salles
Rehabilitation Service, Physiotherapy Department, Hospital Sírio-Libanês, São Paulo, Brazil.
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Christina MM de Brito
Rehabilitation Service, Physiotherapy Department, Hospital Sírio-Libanês, São Paulo, Brazil.
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Abstract

BACKGROUND: Noninvasive ventilation (NIV) has been recognized as an effective strategy in preventing endotracheal intubation in subjects with acute respiratory failure (ARF). Some interface-related complications have also been recognized, such as skin breakdown (SB). The aim of this study was to determine the frequency of SB and identify potential treatment-related risk factors for its development in adults with ARF undergoing NIV or CPAP.

METHODS: A cross-sectional study was conducted in a general hospital. Subjects were retrospectively enrolled in this study if they were > 18 y old and developed ARF caused by any condition in which NIV or CPAP was indicated for at least one application for a period longer than 2 h. The outcomes were the prevalence of SB and the evaluation of related risk factors. Data were extracted from the electronic medical records. A stepwise forward logistic regression model was used to identify independent risk factors for SB development.

RESULTS: A total of 375 subjects (160 males) met the inclusion criteria and were enrolled in the study. Fifty-four subjects (14.4%) developed SB. The mean number of applications of NIV or CPAP carried out for >2 h was higher in subjects with SB (7.1 ± 13.3 h) than in those without SB (4.4 ± 13.3 h) (P = .03). Subjects with SB also presented a higher total duration of NIV use (44.6 ± 118.5 h) compared with subjects without SB (21.8 ± 45.5 h) (P = .01). Subjects who developed SB presented a higher use of oronasal mask (92.6%) compared with the group that did not (21.5%) (P < .001).

CONCLUSIONS: In patients with ARF undergoing NIV or CPAP, oronasal mask use for >26 h was independently associated with development of SB.

  • noninvasive ventilation
  • acute respiratory failure
  • oronasal mask
  • total face mask
  • skin breakdown
  • wrap therapy
  • pressure ulcer

Footnotes

  • Correspondence: Wellington P Yamaguti PhD, Rua Dona Adma Jafet, 91 (Centro de Reabilitação), CEP 01308-050 São Paulo, SP, Brazil. E-mail: wellington.psyamaguti{at}hsl.org.br or wellpsy{at}yahoo.com.br.
  • Dr Yamaguti presented preliminary study results in abstract form at the European Respiratory Society Annual Congress, held September 1–5, 2012, in Vienna, Austria.

  • The authors have disclosed no conflicts of interest.

  • Copyright © 2014 by Daedalus Enterprises Inc.
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Respiratory Care: 66 (4)
Respiratory Care
Vol. 66, Issue 4
1 Apr 2021
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Treatment-Related Risk Factors for Development of Skin Breakdown in Patients With Acute Respiratory Failure Undergoing Noninvasive Ventilation or CPAP
Wellington P Yamaguti, Eliana V Moderno, Sandra Y Yamashita, Thelma GMC Gomes, Ana Lígia V Maida, Claudia S Kondo, Isabel CD de Salles, Christina MM de Brito
Respiratory Care Jun 2014, respcare.02942; DOI: 10.4187/respcare.02942

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Treatment-Related Risk Factors for Development of Skin Breakdown in Patients With Acute Respiratory Failure Undergoing Noninvasive Ventilation or CPAP
Wellington P Yamaguti, Eliana V Moderno, Sandra Y Yamashita, Thelma GMC Gomes, Ana Lígia V Maida, Claudia S Kondo, Isabel CD de Salles, Christina MM de Brito
Respiratory Care Jun 2014, respcare.02942; DOI: 10.4187/respcare.02942
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Keywords

  • noninvasive ventilation
  • acute respiratory failure
  • oronasal mask
  • total face mask
  • skin breakdown
  • wrap therapy
  • pressure ulcer

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