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- Presenter Dr. M. Lubbers and Dr. M. Clark
- Event EWMA 2010 conference, Geneva - Switzerland
- Podcast nr 047
- Length 44:21
Until recently our understanding of pressure ulcer aetiology had made little significant progress since the classic studies of the early 1960’s. These landmark experiments attempted to define the relationship between tissue damage, the magnitude of external pressures and the duration of their application.
Since the 1960’s tissue loading other than direct pressure was accepted as a cause of pressure ulcers but shear forces remained technically challenging to quantify so both their significance in pressure ulcer development and their management in clinical settings remained largely theoretical. Other extrinsic factors have been considered to increase skin and soft tissue vulnerability to prolonged or high external loads, of these the local microclimate (for example temperature and humidity) at the skin-support surface interface has long been viewed as contributing to pressure ulcer development. Like shear forces, the microclimate was challenging to quantify. In consequence little systematic progress has been made towards reducing any deleterious effects caused by changes in skin temperature or humidity.
Recent advances in measurement technologies have opened avenues of research that provide enhanced understanding of the physical effects of pressure and shear. Concurrent interest in the loaded skin’s microclimate may lead to strategies to reduce the effects of loads on the skin and soft tissues. This presentation will focus upon some of the new advances in our understanding of the effects of loading on skin highlighting where these could lead to new or improved ways of preventing pressure ulcers.
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- Presenter Prof. Dr. Paul Trueman
- Event 2009 ESICM congress, Vienna
- Podcast nr 028
- Length 20:35
Aim: Critical care patients are at elevated risk of developing pulmonary complications
such as ventilator-associated pneumonia (VAP); 23% of mechanically ventilated
patients develop VAP. Kinetic therapy (KT) has been shown to aid the prevention
and treatment of VAP. The aim of this study was to determine the financial and clinical impact of KT on VAP in the critical care setting.
Methods: The analysis considers a population of mechanically ventilated patients and explores the impact of moving patients from a standard intensive care unit (ICU) bed, where patients are turned manually, to a KT bed during their critical care stay. The impact of KT beds on VAP episodes, in terms of the length of hospital stay and associated costs relative to conventional beds is estimated, in addition to the number of VAP cases avoided. A hypothetical scenario is presented for a typical medium-sized hospital, which adopts KT devices compared to standard ICU care.
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- Presenter Prof. Dr. Thomas Staudinger
- Event 2009 ESICM congress, Vienna
- Podcast nr 027
- Length 23:15
VAP in the ICU – how to prevent?
Ventilator associated pneumonia (VAP) is a common infectious complication in patients admitted to the intensive care unit (ICU) and it is associated with several risk factors such as duration of mechanical ventilation and factors facilitating microaspiration. VAP is associated with substantially increased morbidity, increased duration of mechanical ventilation and length of stay, as well as increased mortality. Prevention of VAP is therefore one of the foremost aims in mechanically ventilated critically ill patients.
