BACKGROUND:Patients who are comatose or semicomatose are at risk of corneal dryness and ulceration. OBJECTIVE: To compare and evaluate the effectiveness of two treatments used for the prevention of corneal epithelial breakdown in critically ill patients. METHODS: A randomized clinical trial was used. The sample consisted of critically ill patients (age, 15-84 years) with a limited or absent blink reflex in a 14-bed general intensive care unit in a large metropolitan teaching hospital. Ninety-six eligible patients were studied; of these, 36 were excluded and data from the remaining 60 patients were analyzed. Patients were randomized to receive methylcellulose lubricating drops every 2 hours (n = 30) or to have their eyes covered with a polyethylene film to create a moisture chamber (n = 30). The patients' corneas were tested daily for epithelial breakdown using fluorescein drops. Patients were studied for a minimum of 48 hours and a maximum of 1 week. RESULTS: Eight of the 30 patients in the lubricating drop group had positive fluorescein staining, compared with one in the moisture chamber group. CONCLUSION: Our results suggest that a moisture chamber is more effective than lubricating drops in preventing corneal epithelial breakdown in critically ill patients with limited or absent blink reflex.
RCT Entities:
BACKGROUND:Patients who are comatose or semicomatose are at risk of corneal dryness and ulceration. OBJECTIVE: To compare and evaluate the effectiveness of two treatments used for the prevention of corneal epithelial breakdown in critically illpatients. METHODS: A randomized clinical trial was used. The sample consisted of critically illpatients (age, 15-84 years) with a limited or absent blink reflex in a 14-bed general intensive care unit in a large metropolitan teaching hospital. Ninety-six eligible patients were studied; of these, 36 were excluded and data from the remaining 60 patients were analyzed. Patients were randomized to receive methylcellulose lubricating drops every 2 hours (n = 30) or to have their eyes covered with a polyethylene film to create a moisture chamber (n = 30). The patients' corneas were tested daily for epithelial breakdown using fluorescein drops. Patients were studied for a minimum of 48 hours and a maximum of 1 week. RESULTS: Eight of the 30 patients in the lubricating drop group had positive fluorescein staining, compared with one in the moisture chamber group. CONCLUSION: Our results suggest that a moisture chamber is more effective than lubricating drops in preventing corneal epithelial breakdown in critically illpatients with limited or absent blink reflex.
Authors: Martha A Q Curley; John H Arnold; John E Thompson; James C Fackler; Mary Jo Grant; Lori D Fineman; Natalie Cvijanovich; Frederick E Barr; Shirley Molitor-Kirsch; David M Steinhorn; Michael A Matthay; Patricia L Hibberd Journal: J Crit Care Date: 2006-03 Impact factor: 3.425
Authors: Daniel G Ezra; Michelle P Y Chan; Lola Solebo; Aeesha P Malik; Elizabeth Crane; Andrew Coombes; Marie Healy Journal: Intensive Care Med Date: 2008-09-23 Impact factor: 17.440
Authors: Natasha Koroloff; Robert Boots; Jeff Lipman; Peter Thomas; Claire Rickard; Fiona Coyer Journal: Intensive Care Med Date: 2004-03-10 Impact factor: 17.440