RT Journal Article
SR Electronic
T1 Treatment-Related Risk Factors for Development of Skin Breakdown in Patients With Acute Respiratory Failure Undergoing Noninvasive Ventilation or CPAP
JF Respiratory Care
FD American Association for Respiratory Care
SP respcare.02942
DO 10.4187/respcare.02942
A1 Wellington P Yamaguti
A1 Eliana V Moderno
A1 Sandra Y Yamashita
A1 Thelma GMC Gomes
A1 Ana Lígia V Maida
A1 Claudia S Kondo
A1 Isabel CD de Salles
A1 Christina MM de Brito
YR 2014
UL http://rc.rcjournal.com/content/early/2014/06/03/respcare.02942.abstract
AB 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.