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Erschienen in: Intensive Care Medicine 6/2004

01.06.2004 | Original Article

A randomised controlled study of the efficacy of hypromellose and Lacri-Lube combination versus polyethylene/Cling wrap to prevent corneal epithelial breakdown in the semiconscious intensive care patient

verfasst von: Natasha Koroloff, Robert Boots, Jeff Lipman, Peter Thomas, Claire Rickard, Fiona Coyer

Erschienen in: Intensive Care Medicine | Ausgabe 6/2004

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Abstract

Objective

To compare the efficacy of two forms of eye care (hypromellose and Lacri-Lube combination vs polyethylene/Cling wrap covers) for intensive care patients.

Design

Randomised-controlled trial.

Setting

University affiliated, tertiary referral hospital.

Patients and participants

One hundred ten patients with a reduced or absent blink reflex were followed through until they regained consciousness, were discharged from the facility during study enrolment, died or developed a positive corneal ulcer or eye infection.

Interventions

All patients received standard eye cleansing every 2 h. In addition to this, group one (n=60) received a treatment combining hypromellose drops and Lacri-Lube (HL) to each eye every 2 h. Group two (n=50) had polyethylene covers only placed over the eye to create a moisture chamber.

Measurements and results

Corneal ulceration was determined using corneal fluorescein stains and mobile slit lamp evaluation, performed daily. No patients had corneal ulceration in the polyethylene cover group, but 4 patients had corneal ulceration in the HL group.

Conclusions

Polyethylene covers are as effective as HL in reducing the incidence of corneal damage in intensive care patients.
Literatur
1.
Zurück zum Zitat Hernandez EV, Mannis MJ (1997) Superficial keratopathy in intensive care unit patients. Am J Ophthalmol 124:212–216PubMed Hernandez EV, Mannis MJ (1997) Superficial keratopathy in intensive care unit patients. Am J Ophthalmol 124:212–216PubMed
2.
Zurück zum Zitat Imanaka H, Taenaka N, Nakamura J, Aoyama K, Hosotani H (1997) Ocular surface disorders in the critically ill. Anesth Analg 85:343–346PubMed Imanaka H, Taenaka N, Nakamura J, Aoyama K, Hosotani H (1997) Ocular surface disorders in the critically ill. Anesth Analg 85:343–346PubMed
3.
Zurück zum Zitat Lenart SB, Garrity JA (2000) Eye care for patients receiving neuromuscular blocking agents or propofol during mechanical ventilation. Am J Crit Care 9:188–191PubMed Lenart SB, Garrity JA (2000) Eye care for patients receiving neuromuscular blocking agents or propofol during mechanical ventilation. Am J Crit Care 9:188–191PubMed
4.
Zurück zum Zitat Mercieca F, Suresh P, Morton A, Tullo A (1999) Ocular surface disease in intensive care unit patients. Eye 13:231–236PubMed Mercieca F, Suresh P, Morton A, Tullo A (1999) Ocular surface disease in intensive care unit patients. Eye 13:231–236PubMed
5.
Zurück zum Zitat Farrell M, Wray F (1993) Eye care for ventilated patients. Intensive Crit Care Nurs 9:137–141PubMed Farrell M, Wray F (1993) Eye care for ventilated patients. Intensive Crit Care Nurs 9:137–141PubMed
6.
Zurück zum Zitat Cortese D, Capp L, McKinley S (1995) Moisture chamber versus lubrication for the prevention of corneal epithelial breakdown. Am J Crit Care 4:425–428PubMed Cortese D, Capp L, McKinley S (1995) Moisture chamber versus lubrication for the prevention of corneal epithelial breakdown. Am J Crit Care 4:425–428PubMed
7.
Zurück zum Zitat Fleiss J (1981) Statistical methods for rates and proportions. John Wiley, New York Fleiss J (1981) Statistical methods for rates and proportions. John Wiley, New York
8.
Zurück zum Zitat Astori IP, Muller MJ, Pegg SP (1998) Cicatricial, postburn ectropion and exposure keratitis. Burns 24:64–67CrossRefPubMed Astori IP, Muller MJ, Pegg SP (1998) Cicatricial, postburn ectropion and exposure keratitis. Burns 24:64–67CrossRefPubMed
9.
Zurück zum Zitat Spencer T, Hall AH, Stawell R (2002) Ophthalmologic sequelae of thermal burns over ten years at the Alfred Hospital. Ophthal Plast Reconstr Surg 18:196–201CrossRefPubMed Spencer T, Hall AH, Stawell R (2002) Ophthalmologic sequelae of thermal burns over ten years at the Alfred Hospital. Ophthal Plast Reconstr Surg 18:196–201CrossRefPubMed
10.
Zurück zum Zitat Boyd-Monk H, Steinmetz III C (1987) Nursing care of the eye. Appleton and Lange, Norwalk, Connecticut Boyd-Monk H, Steinmetz III C (1987) Nursing care of the eye. Appleton and Lange, Norwalk, Connecticut
11.
Zurück zum Zitat Sullivan J, Brooks-Crawford J, Whitcher J (1999) Lids, lacrimal apparatus and tears. In: Vaughan D, Asbury T, Riordan-Eva P (ed) General ophthalmology. Appleton and Lange, Stamford, Connecticut, pp 74–91 Sullivan J, Brooks-Crawford J, Whitcher J (1999) Lids, lacrimal apparatus and tears. In: Vaughan D, Asbury T, Riordan-Eva P (ed) General ophthalmology. Appleton and Lange, Stamford, Connecticut, pp 74–91
12.
Zurück zum Zitat Gilbard J (2000) Dry-eye disorders. In: Albert D, Jakobiec F (ed) Principles and practice of ophthalmology. WB Saunders, Philadelphia, pp 982–1001 Gilbard J (2000) Dry-eye disorders. In: Albert D, Jakobiec F (ed) Principles and practice of ophthalmology. WB Saunders, Philadelphia, pp 982–1001
13.
Zurück zum Zitat Newell F (1996) Ophthalmology: principles and concepts. Mosby, St. Louis Newell F (1996) Ophthalmology: principles and concepts. Mosby, St. Louis
14.
Zurück zum Zitat Parkin B, Cook S (2000) A clear view: the way forward for eye care on ICU. Intensive Care Med 26:155–156PubMed Parkin B, Cook S (2000) A clear view: the way forward for eye care on ICU. Intensive Care Med 26:155–156PubMed
15.
Zurück zum Zitat Kirwan JF, Potamitis T, el-Kasaby H, Hope-Ross MW, Sutton GA (1997) Microbial keratitis in intensive care. Br Med J 314:433–434 Kirwan JF, Potamitis T, el-Kasaby H, Hope-Ross MW, Sutton GA (1997) Microbial keratitis in intensive care. Br Med J 314:433–434
16.
Zurück zum Zitat Wincek J, Ruttum MS (1989) Exposure keratitis in comatose children. J Neurosci Nurs 21:241–244PubMed Wincek J, Ruttum MS (1989) Exposure keratitis in comatose children. J Neurosci Nurs 21:241–244PubMed
17.
Zurück zum Zitat Lloyd F (1990) Making sense of eye care for ventilated or unconscious patients. Nurs Times 86:36–37 Lloyd F (1990) Making sense of eye care for ventilated or unconscious patients. Nurs Times 86:36–37
18.
Zurück zum Zitat Parkin B, Turner A, Moore E, Cook S (1997) Bacterial keratitis in the critically ill. Br J Ophthalmol 81:1060–1063PubMed Parkin B, Turner A, Moore E, Cook S (1997) Bacterial keratitis in the critically ill. Br J Ophthalmol 81:1060–1063PubMed
19.
Zurück zum Zitat Batra YK, Bali IM (1977) Corneal abrasions during general anesthesia. Anesth Analg 56:363–365PubMed Batra YK, Bali IM (1977) Corneal abrasions during general anesthesia. Anesth Analg 56:363–365PubMed
20.
Zurück zum Zitat Siffring PA, Poulton TJ (1987) Prevention of ophthalmic complications during general anesthesia. Anesthesiology 66:569–570PubMed Siffring PA, Poulton TJ (1987) Prevention of ophthalmic complications during general anesthesia. Anesthesiology 66:569–570PubMed
21.
Zurück zum Zitat Grover VK, Kumar KV, Sharma S, Sethi N, Grewal SP (1998) Comparison of methods of eye protection under general anaesthesia. Can J Anaesth 45:575–577PubMed Grover VK, Kumar KV, Sharma S, Sethi N, Grewal SP (1998) Comparison of methods of eye protection under general anaesthesia. Can J Anaesth 45:575–577PubMed
22.
Zurück zum Zitat Orlin SE, Kurata FK, Krupin T, Schneider M, Glendrange RR (1989) Ocular lubricants and corneal injury during anesthesia. Anesth Analg 69:384–385PubMed Orlin SE, Kurata FK, Krupin T, Schneider M, Glendrange RR (1989) Ocular lubricants and corneal injury during anesthesia. Anesth Analg 69:384–385PubMed
23.
Zurück zum Zitat White E, Crosse MM (1998) The aetiology and prevention of peri-operative corneal abrasions. Anaesthesia 53:157–161CrossRefPubMed White E, Crosse MM (1998) The aetiology and prevention of peri-operative corneal abrasions. Anaesthesia 53:157–161CrossRefPubMed
24.
Zurück zum Zitat Ellis P, Fraunfelder F (1999) Ophthalamic therapeutics. In: Vaughan D, Asbury T, Riordan-Eva P (ed) General ophthalmology. Appleton and Lange, Stamford, Conneticut, pp 57–73 Ellis P, Fraunfelder F (1999) Ophthalamic therapeutics. In: Vaughan D, Asbury T, Riordan-Eva P (ed) General ophthalmology. Appleton and Lange, Stamford, Conneticut, pp 57–73
25.
Zurück zum Zitat Jaanus S (1984) Lubricant preparations. In: Bartlett J, Jaanus S (ed) Clinical ocular pharmacology. Butterworth, London, pp 287–297 Jaanus S (1984) Lubricant preparations. In: Bartlett J, Jaanus S (ed) Clinical ocular pharmacology. Butterworth, London, pp 287–297
26.
Zurück zum Zitat Ommeslag D, Colardyn F, De Laey JJ (1987) Eye infections caused by respiratory pathogens in mechanically ventilated patients. Crit Care Med 15:80–81PubMed Ommeslag D, Colardyn F, De Laey JJ (1987) Eye infections caused by respiratory pathogens in mechanically ventilated patients. Crit Care Med 15:80–81PubMed
27.
Zurück zum Zitat Suresh P, Mercieca F, Morton A, Tullo AB (2000) Eye care for the critically ill. Intensive Care Med 26:162–166PubMed Suresh P, Mercieca F, Morton A, Tullo AB (2000) Eye care for the critically ill. Intensive Care Med 26:162–166PubMed
28.
Zurück zum Zitat Cunningham C, Gould D (1998) Eyecare for the sedated patient undergoing mechanical ventilation: the use of evidence-based care. Int J Nurs Stud 35:32–40CrossRefPubMed Cunningham C, Gould D (1998) Eyecare for the sedated patient undergoing mechanical ventilation: the use of evidence-based care. Int J Nurs Stud 35:32–40CrossRefPubMed
Metadaten
Titel
A randomised controlled study of the efficacy of hypromellose and Lacri-Lube combination versus polyethylene/Cling wrap to prevent corneal epithelial breakdown in the semiconscious intensive care patient
verfasst von
Natasha Koroloff
Robert Boots
Jeff Lipman
Peter Thomas
Claire Rickard
Fiona Coyer
Publikationsdatum
01.06.2004
Verlag
Springer-Verlag
Erschienen in
Intensive Care Medicine / Ausgabe 6/2004
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-004-2203-y

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