Literature DB >> 20079647

A pilot randomised controlled trial comparing reactive air and active alternating pressure mattresses in the prevention and treatment of pressure ulcers among medical ICU patients.

Manu Malbrain1, Bart Hendriks, Patricia Wijnands, Dirk Denie, Anita Jans, Jef Vanpellicom, Bart De Keulenaer.   

Abstract

BACKGROUND: Data on the prevention and treatment of pressure ulcers (PU's) among ICU patients is sparse.
OBJECTIVE: To compare PU outcomes in medial ICU patients nursed on either a reactive mattress overlay (ROHO, ROHO Inc, Belleville, IL, USA) or an active alternating pressure mattress (NIMBUS3, ArjoHuntleigh, Luton Bedfordshire, UK).
DESIGN: Pilot prospective single blind randomised controlled clinical trial. INTERVENTION: Two types of pressure redistributing mattress. PATIENTS: Two groups of eight patients.
METHODS: Patients included in the study were those at high risk (Norton scale <8) or with a PU on admission.
RESULTS: The two groups had similar patient characteristics. However, the NIMBUS 3 group presented with more ulcers per patient on admission (62.5%) and more severe ulcers (20% category 3) while four patients (50%) presented with a single superficial ulcer in the ROHO group. HEALING: The progress of the ulcers showed significant decreases in PU surface area (p=0.05), total PUSH tool score (p=0.01) in the NIMBUS 3 group compared to the ROHO group. In the NIMBUS 3 group 82% of the ulcers improved versus none in the ROHO group (p=0.002) and 18% remained stable versus 33%. None of the ulcers deteriorated in the NIMBUS 3 group versus 67% in the ROHO group (p=0.006). Full thickness wounds (Category 3) were present in 22% of the NIMBUS 3 group versus 0% of the ROHO group on admission and in 0% versus 66.7% (p=0.008) respectively at the end of the pilot study. PREVENTION: Non-blanching erythema occurred equally in both arms at baseline; skin remained intact for the NIMBUS 3 group while 50% in the ROHO group worsened with superficial tissue loss.
CONCLUSION: This small pilot study suggests that 'active' alternating therapy is a useful adjunct in the care of highly vulnerable patients, while the outcomes may be less favourable when using 'reactive', constant low pressure devices. Copyright 2009 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

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Mesh:

Year:  2010        PMID: 20079647     DOI: 10.1016/j.jtv.2009.12.001

Source DB:  PubMed          Journal:  J Tissue Viability        ISSN: 0965-206X            Impact factor:   2.932


  9 in total

1.  Independent risk factors for pressure ulcer development in a high-risk nursing home population receiving evidence-based pressure ulcer prevention: Results from a study in 26 nursing homes in Belgium.

Authors:  Charlotte Anrys; Hanne Van Tiggelen; Sofie Verhaeghe; Ann Van Hecke; Dimitri Beeckman
Journal:  Int Wound J       Date:  2018-11-09       Impact factor: 3.315

2.  Pressure ulcer Cat. II-IV incidence on the CuroCell S.A.M. PRO powered reactive air support surface in a high-risk population: A multicentre cohort study in 12 Belgian nursing homes.

Authors:  Elien Zwaenepoel; Ann Van Hecke; Bénédicte Manderlier; Sofie Verhaeghe; Dimitri Beeckman
Journal:  Int Wound J       Date:  2019-11-11       Impact factor: 3.315

Review 3.  Prevention of pressure ulcers with a static air support surface: A systematic review.

Authors:  Brecht Serraes; Martin van Leen; Jos Schols; Ann Van Hecke; Sofie Verhaeghe; Dimitri Beeckman
Journal:  Int Wound J       Date:  2018-03-05       Impact factor: 3.315

4.  Alternating pressure (active) air surfaces for preventing pressure ulcers.

Authors:  Chunhu Shi; Jo C Dumville; Nicky Cullum; Sarah Rhodes; Asmara Jammali-Blasi; Elizabeth McInnes
Journal:  Cochrane Database Syst Rev       Date:  2021-05-10

5.  Alternative reactive support surfaces (non-foam and non-air-filled) for preventing pressure ulcers.

Authors:  Chunhu Shi; Jo C Dumville; Nicky Cullum; Sarah Rhodes; Elizabeth McInnes
Journal:  Cochrane Database Syst Rev       Date:  2021-05-06

6.  Beds, overlays and mattresses for treating pressure ulcers.

Authors:  Chunhu Shi; Jo C Dumville; Nicky Cullum; Sarah Rhodes; Asmara Jammali-Blasi; Victoria Ramsden; Elizabeth McInnes
Journal:  Cochrane Database Syst Rev       Date:  2021-05-10

7.  Reactive air surfaces for preventing pressure ulcers.

Authors:  Chunhu Shi; Jo C Dumville; Nicky Cullum; Sarah Rhodes; Vannessa Leung; Elizabeth McInnes
Journal:  Cochrane Database Syst Rev       Date:  2021-05-07

8.  Foam surfaces for preventing pressure ulcers.

Authors:  Chunhu Shi; Jo C Dumville; Nicky Cullum; Sarah Rhodes; Elizabeth McInnes
Journal:  Cochrane Database Syst Rev       Date:  2021-05-06

9.  Support surfaces for treating pressure ulcers.

Authors:  Elizabeth McInnes; Asmara Jammali-Blasi; Sally Em Bell-Syer; Vannessa Leung
Journal:  Cochrane Database Syst Rev       Date:  2018-10-11
  9 in total

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