Biomedical subjects

C Theaker

Publications and source records attributed to C Theaker.

6 recordsLinked to original sources

PubMed2005

Pressure ulcer prevention in intensive care - a randomised control trial of two pressure-relieving devices.

Pressure sores are a potential complication of intensive care. Modern methods of pressure sore prevention centre around the use of pressure-relieving devices. Few studies exist that confirm the effectiveness of these devices. This study evaluates the effectiveness of two devices, the Hill-Rom Duo mattress and the KCI TheraPulse. High-risk patients were randomly assigned to receive one of two devices. We excluded those patients who had pressure sores upon admission. Those patients that did develop a pressure sore had their wound digitally photographed and graded by two independent tissue viability nurses. Sixty-two patients were included (30 TheraPulse, 32 Duo. Nine developed a pressure sore (6 Duo, 3 TheraPulse). No statistical differences between the two devices could be found. The longer a patient was nursed on a device, the greater the risk of pressure sore development. Despite the use of these devices, pressure sores can still develop in the Intensive Care patient population.

Adult↗

PubMed2003

Pressure sore prevention in the critically ill: what you don't know, what you should know and why it's important.

The critically ill are particularly vulnerable to pressure sore development. These expensive and often painful complications have been largely ignored for many years and the entire problem has been managed by nursing staff. Current methods for identifying patients at risk are inadequate and subjective. Scoring systems have been known to over-predict those at risk and this maybe because they frequently originate from elderly care settings. Additionally, their relevance to the critically ill has not yet been established. The use of pressure-relieving devices has become commonplace; however, there is a paucity of data from controlled clinical studies. No uniform approach in measuring the effectiveness of these devices exists. What is certain, though, is that a voluminous amount of work needs to be conducted in order to verify their continued use. It is increasingly apparent that the complex nature of pressure sore development means that it is unrealistic to expect a single discipline to manage the problem effectively. A multidisciplinary team approach is the most appropriate way to improve management in this vital area.

Critical Illness↗

PubMed2003

The impact of Acinetobacter baumannii in the intensive care unit.

Acinetobacter baumannii is a significant problem in critically ill patients. It is widespread, can colonise patients quickly and causes virulent infections. However, its overall impact on morbidity and mortality in the critically ill remains unmeasured. This study was designed to investigate A. baumannii colonisation and infection rates in a critically ill population over an 18-month period. Twenty-seven patients from a population of 347 were identified as having A. baumannii. Sixteen were colonised, whereas 11 were infected. Eleven of the 27 patients with A. baumannii died (41%). Of these, eight were colonised and three were infected. In the same period, 320 patients did not have A. baumannii and their mortality rate was 20% (n = 64). The mortality rate of patients with A. baumannii was significantly higher than that of patients without infection.

Acinetobacter Infections↗

PubMed2002

Comparison of bacterial colonization rates of antiseptic impregnated and pure polymer central venous catheters in the critically ill.

A study was performed on critically ill patients to evaluate the rate of colonization and catheter-related sepsis using antiseptic bonded (Arrowguard Arrow International) versus smooth pure polymer (Infectguard MedexMedical Ltd) central venous catheters. Two hundred and thirty-two catheters were inserted into 181 patients. Indications for removal included local or systemic infection, the catheter was no longer required and patient death. No statistical difference in colonization rate was found between the two types of catheter.

Anti-Infective Agents, Local↗

PubMed2001

MRSA in the critically ill.

MRSA colonization and infection rates were prospectively examined over an 18 month period in a general Intensive Care Unit. Of 642 admissions, 305 were in ICU for longer than 48 h and were hence included and a further three patients were already colonized at admission but stayed less than 48 h. Ninety-seven patients were colonized with MRSA including 19 who were already colonized at admission. There were 56 episodes of clinical infection in 43 patients. The mortality rates in the colonized and infected groups, were 14.8% and 16.2% respectively, while the rate in those not colonized was 23%. These figures were not statistically different. Those colonized or infected with MRSA had significantly longer ICU stays than those not colonized. Sputum colonization and infection was a major site for MRSA. There was diagnostic certainty of MRSA infection in 40% of cases emphasizing the difficulty in diagnosis of infection due to MRSA in the critically ill. Both colonization and infection with MRSA are associated with longer ICU stay but do not appear to influence mortality.

Hospital Mortality↗

PubMed2000

Risk factors for pressure sores in the critically ill.

Pressure sore development in the critically ill is a well-recognised problem and several risk factors have been put forward as being relevant; however, none has been proved valid in this population. This study examines the effects of specific risk factors for the development of pressure sores in the critically ill. Data on 22 specific risk factors were recorded every 8 h. Of 286 patients who were identified as having a minimum set of three predetermined risk factors, 77 developed pressure sores. Using univariate regression analysis, 18 of the 22 specific factors were identified as being significant (p < 0.05) in the development of pressure sores. Multivariate analysis identified five of these 18 specific risk factors as being independently significant (p < 0.05) in pressure sore development. These five factors were norepinephrine infusion, APACHE II score, faecal incontinence, anaemia and length of stay.

Critical Care↗