Turning and repositioning the critically ill patient with hemodynamic instability: A literature review and consensus recommendations

Journal of Wound, Ostomy and Continence Nursing

Volumn 40, Issue 3, 2013, Pages 254-267

  Tod Brindle, C ^a   Malhotra, Rajiv ^a   O'rourke, Shelby ^a   Currie, Linda ^a   Chadwik, Debbie ^a   Falls, Pam ^a   Adams, Christi ^a   Swenson, Jacob ^b   Tuason, Dhol ^a   Watson, Stephanie ^a   Creehan, Sue ^a  

^a VIRGINIA COMMONWEALTH UNIVERSITY MEDICAL CENTER   (United States)

^b Evans Hayes Burn Center   (United States)

Author keywords

Hemodynamic instability; Intensive care; Pressure ulcer; Progressive mobility; Repositioning; Turning

Indexed keywords

BED REST; CONSENSUS; CRITICAL ILLNESS; DECUBITUS; HEMODYNAMICS; HUMAN; INTENSIVE CARE UNIT; NURSING; PATIENT POSITIONING; REVIEW;

BED REST; CONSENSUS; CRITICAL ILLNESS; HEMODYNAMICS; HUMANS; INTENSIVE CARE UNITS; PATIENT POSITIONING; PRESSURE ULCER;

EID: 84880179712     PISSN: 10715754     EISSN: None     Source Type: Journal    
DOI: 10.1097/WON.0b013e318290448f     Document Type: Review

References (69)

1. Agency for Healthcare Research and Quality . Pressure ulcers among hospitalized patients . AHRQ News Numbers. 2008 . http://archive.ahrq.gov/news/ nn/nn120308.htm . Accessed June 21, 2011.
2. University Healthcare Consortium . Guide for change-pressure ulcers . Webinar Present . https://www.uhc.edu/33468 . Accessed March 10, 2010 .
3. Lyder CH . Pressure ulcer prevention and management . JAMA. 2003; 289 ( 2 ): 223-226 .
4. Yankowsky K . Lawsuits, technology and wounds: how electronic records change your practice . Presented at the 43rd Annual Wound Ostomy Continence Nurses Society Conference; June 4-8, 2011; New Orleans, LA.
5. Berlowitz D, Brienza D . Are All Press ure Ulcers the Result of Deep Tissue Injury ? 2009 . http://www.o-wm.com/article/7930. Accessed December 28, 2010.
6. Black J . Deep tissue injury: an evolving science . Ostomy Wound Manage . 2009; 55 ( 2 ). http://www.o-wm.com/content/deeptissue-injury-an-evolving- science . Accessed July 7, 2010.
7. Ceelen K, Gawlitta D, Bader DL, Oomens CWJ. Numerical analysis of ischemia- and compression-induced injury in tissue- engineered skeletal muscle constructs . Ann Biomed Eng. 2009; 38 ( 3 ): 570-582 .
8. Lin F, Pandya A, Cichowski A, et al. Deep tissue injury rat model for pressure ulcer research on spinal cord injury . J Tissue Viabil. 2010; 19 : 67-76 .
9. Makhsous M, Pandya A, Pandya M, Chadwick C . Elevation in the serum and urine concentration of injury-related molecules after the formation of deep tissue injury in rat spinal cord injury pressure ulcer model . PM&R. 2010; 2 : 1063-1065 .
10. Oomens CWJ, Loerakker S, Bader DL . The importance of internal strain as opposed to interface pressure in the prevention of pressure related deep tissue injury . J Tissue Viabil. 2009; 19 : 35-42 .
11. Shabshin N, Ougortsin V, Zoizner G, Gefen A . Evaluation of the effect of trunk tilt on compressive soft tissue deformations under the ischial tuberosities using weight-bearing MRI . Clin Biomech. 2010; 25 : 402-408 .
12. Sopher R, Nixon J, Gorecki C, Gefen A . Exposure to internal muscle tissue loads under the ischial tuberosities during sitting is elevated at abnormally high or low body mass indices . J Biomech. 2010; 43 : 280-286 .
13. Edsberg L . Pressure ulcer tissue histology: an appraisal of current knowledge . Ostomy Wound Manage . 2010 . http://www.o-wm.com/article/7934. Accessed February 4, 2011.
14. Farid K . Applying observations from forensic science to understanding the development of pressure ulcers . Ostomy Wound Manage. 2010 . http://www.o-wmcom/article/7063 . Accessed June 21, 2011.
15. Mao C, Rivet A, Sidora T, Pasko M . Update on pressure ulcer management and deep tissue injury . Ann Pharmacother. 2010; 44 : 325-332 .
16. Slowikowsk G, Funk M . Factors associated with pressure ulcers in patients in a surgical intensive care unit . J Wound Ostomy Continence Nurs. 2010; 37 ( 6 ): 619-626 .
17. Krishnagopalan S, Johnson W, Low LL, Kaufman LJ . Body position of intensive care patients: clinical practice versus standards . Crit Care Med. 2002; 30 : 2588-2592 .
18. Berke C, Black J . Retrospective study to identify a risk profi le for pressure related deep tissue injury . J Wound Ostomy Continence Nurs . 2007; 35 ( 3s ): S61 .
19. Porkorny M, Koldjeski D, Swanson M . Skin care intervention for patients having cardiac surgery . Am J Crit Care. 2003; 12 : 535-544 .
20. Solis L, Gyawali S, Seres P, et al. Effects of intermittent electrical stimulation on superfi cial pressure, tissue oxygenation and discomfort levels for the prevention of deep tissue injury . Ann Biomed Eng. 2011; 39 ( 2 ): 649-663.
21. Kortebein P, Symons TB, Ferrando A, et al. Functional impact of 10 days of bed rest in healthy older adults . J Gerontol. 2008; 63 ( 10 ): 1076-1081 .
22. Shoemake S, Stoessel K . The clinical issue: pressure ulcers in the surgical patient . http://www.haiwatch.com/upload/tools/H0277-0701-CI-Pressure- Ulcer.pdf . Accessed May 26, 2011 .
23. De Laat EH, Pickkers P, Schoonhoven L, Verbeek AL, Feuth T, van Achterberg T . Guideline implementation results in a decrease of pressure ulcer incidence in critically ill patients . Crit Care Med. 2007; 35 ( 3 ): 815-820 .
24. Peerless JR, Davies A, Klein D, Yu D . Skin complications in the intensive care unit . Clin Chest Med. 1999; 20 ( 2 ): 453-467 .
25. Offner PJ, Haenel JB, Moore EE, Biff WL, Franciose RJ, Burch JM . Complications of prone ventilation in patients with multisystem trauma with fulminant acute respiratory distress syndrome . J Trauma. 2000; 49 ( 4 ): 791-792 .
26. National Pressure Ulcer Advisory Panel . Position statement: not all pressure ulcers are avoidable . http://www.npuap.org/A-UA%20Press%20Release.pdf . Accessed March 3, 2010 .
27. Brower R . Consequences of bed rest . Crit Care Med. 2009; 37 ( 10 ) ( suppl ): S422-S428 .
28. Winkelman C . Bed rest in health and critical illness: a body systems approach . AACN Adv Crit Care. 2009; 20 ( 3 ): 254-266 .
29. Aissaoui N, Martins E, Mouly S, Weber S, Meune C . A metaanalysis of bed rest versus early ambulation in the management of pulmonary embolus, deep vein thrombosis, or both . Int J Cardiol. 2008; 137 : 37-41 .
30. Winkelman C, Peereboom K . Staff-perceived barriers and facilitators . Crit Care Nurse. 2010; 30 : 13-16 .
31. De Jonghe B, Lacherade JC, Shashar T, Outin H . Intensive care unit-acquired weakness: risk factors and prevention . Crit Care Med. 2009; 37 ( 10 ): s309-s315 .
32. Bailey P, Thomsen GE, Spuhler VJ, et al. Early activity is feasible and safe in respiratory failure patients . Crit Care Med . 2007; 35 ( 1 ): 139-145 .
33. Morris PE, Goad A, Thompson C, et al. Early intensive care unit mobility therapy in the treatment of acute respiratory failure . Crit Care Med . 2008; 36 ( 8 ): 2238-2243 .
34. Kortebein P, Symons TB, Ferrando A, et al. Functional impact of 10 days of bed rest in healthy older adults . J Gerontol. 2008; 63 ( 10 ): 1076-1081 .
35. Lingren M, Unosson M, Fredrikson M, Ek AC . Immobility-a major risk factor for development of pressure ulcers among adult hospitalized patients: a prospective study . Scand J Caring Sci. 2004; 18 : 57-64 .
36. Stekelenberg A, Gawlitta D, Bader D, Oomens C . Deep tissue injury: how deep is our understanding ? Arch Phys Med Rehabil. 2008; 89 : 1410-1413 .
37. Choi J, Tasota FJ, Hoffman LA . Mobility interventions to improve outcomes in patients undergoing prolonged mechanical ventilation: a review of literature . Biol Res Nurs. 2008; 10 ( 1 ): 21-33 .
38. Winslow EH, Clark AP, White KM, Tyler DO . Effects of a lateral turn on mixed venous oxygen saturation and heart rate in critically ill adults . Heart Lung. 1990; 19 : 557-561 .
39. Vollman K . Introduction to progressive mobility . Crit Care Nurse . 2010; 30 : 3-5 .
40. Winslow EH, Lane LD, Woods RJ . Dangling: a review of relevant physiology, research and practice . Heart Lung. 1995; 24 : 263-272 .
41. Coupe M, Fortrat JO, Larina I, Gauquelin-Koch G, Gharib C, Custaud MA . Cardiovascular deconditioning: from autonomic nervous system to microvascular functions . Respir Physiol Neurobiol. 2009; 169s : s10-s12 .
42. Offner PJ, Haepel JB, Moore EE, Bliff WL, Franciose RJ, Burch JM . Complications of prone ventilation in patients with multisystem trauma with fulminant acute respiratory distress syndrome . J Trauma . 2000; 48 ( 2 ): 224-228 .
43. Armstrong D, Ayello E, Capitulo K, et al. New opportunities to improve pressure ulcer prevention and treatment: implications of the CMS inpatient Hospital Care Present on Admission (POA) Indicators/Hospital-Acquired Conditions (HAC) Policy; 2008 . http://www.medline.com/media-room/pdf/Opportunities-to- Improve-Pressure-Ulcer-Prevention-and-Treatment.pdf Accessed March 27, 2011.
44. National Pressure Ulcer Advisory Panel and European Pressure Ulcer Advisory Panel . Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline . Washington, DC : National Pressure Ulcer Advisory Panel; 2009 . http://www.npuap.org.
45. Braden BJ, Bergstrom N . Clinical utility of the Braden Scale for predicting pressure sore risk . Decubitus. 1989; 2 ( 3 ): 44 .
46. Creehan M, Brindle CT . CSI: who are you ? Nurs Manage. September 2010 : 50-53 .
47. Creehan MS, Brindle CT . Stoplight System for Pressure Ulcer Risk Assessment . Nursing 2011 . September; 41(9):67. doi: 10.1097/01.NURSE. 0000403275.14170.4b.
48. Brindle CT . Outliers to the Braden Scale: identifying high risk ICU patients and the results of prophylactic dressing use . WCET J. 2009; 30 ( 1 ): 11-18 .
49. Goldhill DR, Imhoff M, McLean B, Waldmann C . Rotational bed therapy to prevent and treat respiratory complications: a review and meta-analysis . Am J Crit Care. 2007; 16 ( 1 ): 50-61 .
50. Swadener-Culpepper L, Skaggs RL, Vangilder CA . The impact of continuous lateral rotation therapy in overall clinical and fi nancial outcomes of critically ill patients . Crit Care Nurs Q. 2008; 31 ( 3 ): 270-279 .
51. Anderson C, Rappl L . Feature: lateral rotation mattresses for wound healing . Ostomy Wound Manage. 2007 . http//:www.o-wm.com/article/2507 . Accessed October 18, 2007.
52. Black J . Deep tissue injury: state of the science . Paper presented at: Grand Rounds Presentation Lecture Virginia Commonwealth University Medical Center; December 3, 2010; Richmond, VA .
53. Turpin P, Pemberton V . Prevention of pressure ulcers in patients being managed on CLRT: is supplemental repositioning needed ? J Wound Ostomy Continence Nurs. 2006; 33 ( 4 ): 381-388 .
54. Sylvia C . To reposition or not to reposition during lateral rotation... That is the question . Poster presented at: The 40th Annual Wound Ostomy Continence Nurses Society Conference; June 21-25, 2008; Orlando, FL .
55. Defloor T, Grypdonck M, De Bacquer D . The effect of various combinations of turning and pressure reducing devices on the incidence of pressure ulcers . Int J Nurs Stud. 2005; 42 ( 1 ): 37-46 .
56. Black J, Edsberg L, Baharestani M, et al. Pressure ulcers: avoidable or unavoidable ? Results of the national pressure ulcer advisory panel consensus conference. Ostomy Wound Manage. 2011; 57 ( 2 ): 24-37 .
57. Perme C, Chandrashekar R . Early mobility and walking program for patients in intensive care units: creating a standard of care . Am J Crit Care. 2009; 18 ( 3 ): 212-221 .
58. Chulay M, Brown J, Summer W . Effect of postoperative immobilization after coronary artery bypass surgery . Crit Care Med . 1982; 10 ( 3 ): 176-179 .
59. Jones B . The effects of patient repositioning on intracranial pressure . Aust J Adv Nurs. 1994; 12 ( 2 ): 32-39 .
60. O'Connor ED, Walsham J . Should we mobilise [ sic ] critically ill patients? A review . Crit Care Resusc. 2009; 11 ( 4 ): 290-300 .
61. Morris PE, Goad A, Thompson C, et al. Early intensive care unit mobility therapy in the treatment of acute respiratory failure . Crit Care Med. 2008; 36 ( 8 ): 2444-2445 .
62. Griffiths RD, Hall JB . Intensive care unit-acquired weakness . Crit Care Med. 2010; 38 ( 3 ): 779-787 .
63. Kress JP. Clinical trials of early mobilization of critically ill patients . Crit Care Med. 2009; 37 ( 10s ): s442-s447 .
64. Rochester C . Rehabilitation in the intensive care unit . Semin Respir Crit Care Med. 2009; 30 : 656-669 .
65. Troung AD, Fan E, Brower RG, Needham DM . Bench-to-bedside review: mobilizing patients in the intensive care unit-from pathophysiology to clinical trials . Crit Care. 2009; 13 : 216 . doi:10, 1186/cc7885.
66. Wound Ostomy Continence Nurses Society . Position statement on avoidable versus unavoidable pressure ulcers . J Wound Ostomy Continence Nurs. 2009; 36 ( 4 ): 378-381 .
67. Duran-Valdez E, de Serna DG, Schneider S, Amorim F, Burge M, Schade DS . Metabolic effects of 2 days of strict bed rest . Endocr Pract. 2008; 14 ( 5 ): 564-569 .
68. Topp R, Ditmyer M, King K, et al. The effect of bedrest and potential prehabilitation on patients in the intensive care unit . AACN Clin Issues . 2002; 13 ( 2 ): 263-276 .
69. De Jonghe B, Bastuji-Garin S, Durand MC, et al. Respiratory weakness is associated with limb weakness and delayed weaning in critical illness . Crit Care Med . 2007; 39 : 2007-2015 .