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Lim KW, Ha SY, Kang IS. [Effectiveness of the Eye Care Protocol in the Intensive Care Unit Patients: A Randomized Controlled Trial]. J Korean Acad Nurs 2024; 54:432-445. [PMID: 39248427 DOI: 10.4040/jkan.24017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 05/07/2024] [Accepted: 06/11/2024] [Indexed: 09/10/2024]
Abstract
PURPOSE This study investigated the effects of an eye care protocol (ECP) on patients in the intensive care unit (ICU). METHODS This study utilized a randomized controlled design. Participants were patients who met the inclusion criteria and were admitted to the ICU (36 in the experimental group and 38 in the control group). The experimental group received an ECP, while the control group received standard eye care, starting the day after admission, for a duration of 10 days. The ECP classifies the degree of eyelid obstruction into three stages based on the degree of exposure to the lower eyelid conjunctiva and cornea. The protocol included cleansing with normal saline gauze, administering eye drops, applying silicone and polyurethane films, and recommending consultation with an ophthalmologist if necessary. The effectiveness of ECP was assessed by analyzing tear volume, hyperemia, chemosis, and eye discharge. Data analysis was conducted using SPSS 27.0, employing the Mann-Whitney U-test and generalized estimating equations. RESULTS On day 5, the experimental group demonstrated a significant increase in tear volume in both eyes compared with the control group. However, no statistically significant differences were observed in the incidence of hyperemia, chemosis, and eye discharge on days 5 and 10 of the intervention. CONCLUSION The application of the ECP in this study increased tear volume in ICU patients, thereby reducing discomfort caused by dry eyes. It has the potential to prevent complications such as damage to the surface of the eyeball resulting from decreased tear volume.
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Affiliation(s)
- Kyu Won Lim
- Emergency Intensive Care Unit, Pusan National University Hospital, Busan, Korea
| | - Shin Young Ha
- College of Nursing, Pusan National University, Yangsan, Korea.
| | - In Soon Kang
- College of Nursing, Pusan National University, Yangsan, Korea
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de Oliveira Pinheiro CE, Carneiro E Silva RS, de Sousa FREG, Mantilla NPM, Silva NND, de Assis SF, do Prado PR. Causal validation of the risk for corneal injury in critically ill adults. Nurs Crit Care 2023; 28:1053-1060. [PMID: 35045203 DOI: 10.1111/nicc.12747] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The validity of a nursing diagnosis depends on a continuous investigation process in different populations to provide clinical evidence. The risk for corneal injury nursing diagnosis was approved in 2013 and only reviewed in 2017, demonstrating the need to perform a clinical validation to improve it. AIM To perform a causal validation of the risk for corneal injury nursing diagnosis in critically ill adults. STUDY DESIGN A prospective cohort study was performed in two intensive critical care units in Northern Brazil with adults aged over 18 years without corneal injury at admission. The patients were evaluated for 10 days, using a data collection tool composed of risk factors for the risk for corneal injury nursing diagnosis. The independent variables were described through absolute and relative frequency. The accuracy measures and risk factors were identified through Cox regression, considering a 95% confidence interval. RESULTS The nurses assessed 209 critically ill adults and identified that 76.0% of them presented the risk for corneal injury nursing diagnosis, with 16.3% developing a corneal injury, all having previously presented the risk for corneal injury nursing diagnosis. The risk factors identified were eyeball exposure (hazard ratio: 1.78; 95% CI: 1.27-2.51), Glasgow score < 6 (hazard ratio: 1.73; 95% CI: 1.15-2.60) and periorbital oedema (hazard ratio: 1.43; 95% CI: 1.03-1.99), with these factors showing high specificity, and the mechanical ventilation variable, showing high sensitivity, with ROC curve of .86. CONCLUSION Eyeball exposure, Glasgow score < 6 and periorbital oedema are the risk factors of the risk for corneal injury nursing diagnosis, in critically ill adults. These risk factors guide nursing interventions. This causal validation can improve the risk for corneal injury nursing diagnosis levels of evidence in the NANDA International Taxonomy. RELEVANCE TO CLINICAL PRACTICE It is necessary to guide nursing interventions for critically ill adults with lowered level of consciousness and corneal exposure for the prevention of corneal injury.
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Affiliation(s)
| | | | | | | | | | | | - Patrícia Rezende do Prado
- Federal University of Acre, Rio Branco, Brazil
- Post-doctoral Student at Department of General and Specialized Nursing, University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil
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Krüger L, Weiss C, Hermes C, Dierkes F, Oldag A, Peper L, Tropmann J, Vogt S, Wefer F. [Treatment algorithm: eye care for critically ill patients]. Med Klin Intensivmed Notfmed 2023; 118:483-486. [PMID: 37318533 DOI: 10.1007/s00063-023-01025-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2023] [Indexed: 06/16/2023]
Affiliation(s)
- Lars Krüger
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland.
- Stabsstelle Projekt- und Wissensmanagement/Pflegeentwicklung Intensivpflege, Pflegedirektion, Herz- und Diabeteszentrum NRW, Universitätsklinik der Ruhr-Universität Bochum, Georgstraße 11, 32345, Bad Oeynhausen, Deutschland.
| | - Claudia Weiss
- Chirurgische Intensivstation, Universitätsklinikum Bonn, Bonn, Deutschland
| | - Carsten Hermes
- Studiengang "Erweiterte Klinische Pflege M.Sc und B.Sc.", Akkon-Hochschule für Humanwissenschaften, Berlin, Deutschland
- Hochschule für angewandte Wissenschaften Hamburg (HAW), Hamburg, Deutschland
| | - Franziska Dierkes
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Anne Oldag
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Lisa Peper
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Jenny Tropmann
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Sarah Vogt
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Franziska Wefer
- Stabsstelle Pflegeentwicklung, Pflegedirektion, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
- Arbeitskreis Evidence-based Nursing (AK EBN), Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
- Institut für Pflegewissenschaft, Medizinische Fakultät und Universitätsklinik Köln, Universität zu Köln, Köln, Deutschland
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Abrishami M, Omidtabrizi A. Response to "Comment On: Ocular Manifestations of Hospitalized Patients with COVID-19 in Northeast of Iran". Ocul Immunol Inflamm 2021; 29:698-699. [PMID: 34242120 DOI: 10.1080/09273948.2021.1903940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Mojtaba Abrishami
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Arash Omidtabrizi
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Shimizu E, Yazu H, Aketa N, Yokoiwa R, Sato S, Katayama T, Hanyuda A, Sato Y, Ogawa Y, Tsubota K. Smart Eye Camera: A Validation Study for Evaluating the Tear Film Breakup Time in Human Subjects. Transl Vis Sci Technol 2021; 10:28. [PMID: 34004005 PMCID: PMC8083120 DOI: 10.1167/tvst.10.4.28] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/13/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose This study aimed to demonstrate the efficacy of a "Smart Eye Camera (SEC)" in comparison with the efficacy of the conventional slit-lamp microscope by evaluating their diagnostic functionality for dry eye disease (DED) in clinical cases. Methods This retrospective study included 106 eyes from 53 adult Japanese patients who visited the Ophthalmology outpatient clinics in Keio University Hospital from June 2019 to March 2020. Tear film breakup time (TFBUT) and corneal fluorescence score (CFS) measurements for the diagnosis of DED were compared between the conventional slit-lamp microscope and SEC. Results The objective findings of DED showed that there was a strong correlation between the conventional slit-lamp microscope and SEC with respect to TFBUT and CFS results (Spearman's r = 0.887, 95% confidence interval [CI] = 0.838-0.922, and r = 0.920, 95% CI = 0.884-0.945, respectively). The interobserver reliability between the conventional slit-lamp microscope and SEC showed a moderate agreement (weighted Kappa κ = 0.527, 95% CI = 0.517-0.537 and κ = 0.550, 95% CI = 0.539-0.561 for TFBUT and CFS, respectively). The diagnostic performance of the SEC for Asia Dry Eye Society diagnostic criteria showed a sensitivity of 0.957 (95% CI = 0.841-0.992), specificity of 0.900 (95% CI = 0.811-0.927), positive predictive value of 0.880 (95% CI = 0.774-0.912), and negative predictive value of 0.964 (95% CI = 0.869-0.993). Moreover, the area under the receiver operating characteristic curve was 0.928 (95% CI = 0.849-1.000). Conclusions Compared with the conventional slit-lamp microscope, SEC has sufficient validity and reliability for diagnosing DED in the clinical setting. Translational Relevance The SEC can portably evaluate TFBUT in both basic research and clinical care.
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Affiliation(s)
- Eisuke Shimizu
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- OUI Inc., Tokyo, Japan
| | - Hiroyuki Yazu
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- OUI Inc., Tokyo, Japan
- Department of Ophthalmology, Tsurumi University School of Dental Medicine, Kanagawa, Japan
| | - Naohiko Aketa
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- OUI Inc., Tokyo, Japan
| | | | - Shinri Sato
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Taiichiro Katayama
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Akiko Hanyuda
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan
| | - Yoko Ogawa
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
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Di Pietro S, Giannetto C, Falcone A, Piccione G, Congiu F, Staffieri F, Giudice E. Dexmedetomidine and Tear Production: Evaluation in Dogs as Spontaneous Model for Ocular Surface Disorders. Vet Sci 2021; 8:vetsci8020028. [PMID: 33669215 PMCID: PMC7919802 DOI: 10.3390/vetsci8020028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 02/07/2021] [Accepted: 02/13/2021] [Indexed: 12/30/2022] Open
Abstract
Simple Summary The general anesthesia or sedation reduces both the tear production and the stability of tear film that protect corneal surface, predisposing itself to the exposure keratopathy. The aim of the present study was to evaluate the effects of intramuscular dexmedetomidine (DEX) on canine tear production, measured by standardized Schirmer Tear Test 1 (STT-1) strips, for the 8 h following sedation, in dogs. A significant effect of time on canine tear production was found, highlighting that dexmedetomidine sedative protocol significantly affects tear production in dogs. It is recommended to treat the canine eyes with tear substitutes to protect ocular surface health and the welfare of the dogs. The ocular lubrication should be performed during and up to 12 h after sedation. The present report could provide preliminary information to better understand the effect of DEX on the tear film dynamics. Abstract Tear film provides lubrication and protection to the ocular surface. The sedation reduces tear production, often leading to perioperative exposure keratopathy. The aim of the present study was to report the effects of intramuscular dexmedetomidine on canine tear production, measured by STT-1, for an experimental period of 8 h after sedation. Ten dogs who underwent sedation for routine radiologic assessment were recruited for the study. In all animals, tear production in right and left eyes was measured 15 min before sedation (T0: basal values) and 20 min (T20), 1 h (T1), 2 h (T2), 4 h (T4) and 8 h (T8) after drug administration. Analysis of variance and post hoc Bonferroni test (p < 0.05) were performed. A significant effect of time on canine tear production was found. The tear production returned to basal values at T8. So, it is recommended to treat the canine eyes with tear substitutes during and up to 12 h after sedation.
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Affiliation(s)
- Simona Di Pietro
- Department of Veterinary Sciences, University of Messina, Viale Palatucci, 98168 Messina, Italy; (C.G.); (A.F.); (G.P.); (F.C.); (E.G.)
- Correspondence: ; Tel.: +39-0906-766-758; Fax: +39-0906-766-979
| | - Claudia Giannetto
- Department of Veterinary Sciences, University of Messina, Viale Palatucci, 98168 Messina, Italy; (C.G.); (A.F.); (G.P.); (F.C.); (E.G.)
| | - Annastella Falcone
- Department of Veterinary Sciences, University of Messina, Viale Palatucci, 98168 Messina, Italy; (C.G.); (A.F.); (G.P.); (F.C.); (E.G.)
| | - Giuseppe Piccione
- Department of Veterinary Sciences, University of Messina, Viale Palatucci, 98168 Messina, Italy; (C.G.); (A.F.); (G.P.); (F.C.); (E.G.)
| | - Fulvio Congiu
- Department of Veterinary Sciences, University of Messina, Viale Palatucci, 98168 Messina, Italy; (C.G.); (A.F.); (G.P.); (F.C.); (E.G.)
| | - Francesco Staffieri
- Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy;
| | - Elisabetta Giudice
- Department of Veterinary Sciences, University of Messina, Viale Palatucci, 98168 Messina, Italy; (C.G.); (A.F.); (G.P.); (F.C.); (E.G.)
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