Protocolized eye care prevents corneal complications in ventilated patients in a medical intensive care unit

Abstract

Background:Eye care is an essential component in the management of critically ill patients. Standardized eye care can prevent corneal complications in ventilated patients.Objective:This study was designed to compare old and new practices of corneal care for reduction in corneal complications in ventilated patients.Methods:This study was done in three phases each of six month duration. Phase 1 was the ongoing practice of eye care in the unit. Before the start of phase 2, a new protocol was made for eye care. Corneal complications were observed in terms of haziness, dryness, and ulceration. All nursing staffs were educated and made compliant with the new protocol. In phase 2, a follow-up audit was done to check the effectiveness and compliance to protocol. In phase 3, a follow-up audit was started 3 months after phase 2.Results:In phase 1, total ventilated patients were 40 with 240 ventilator days. The corneal dryness rate was 40 per 1000 ventilator days while the haziness and ulceration rate was 16 per 1000 ventilator days each. In the second phase 2, total ventilated patients were 53 making 561 ventilator days. The rate of corneal haziness and dryness was 3.52 and 1.78 per 1000 ventilator days, respectively, with no case of corneal ulceration. In phase 3, the number of ventilated patients was 91 with 1114 ventilator days. The corneal dryness rate was 2.69 while the haziness and ulceration rate was 1.79 each.Conclusion:Protocolized eye care can reduce the risk of corneal complications in ventilated patients.

Incidence, risk factors and impact of protocolised care on exposure keratopathy in critically ill adults: a two-phase prospective cohort study

“…incomplete eye closure and mechanical ventilation or sedation. A myriad of complex assessment methods have been suggested [ 22 , 28 , 29 ] but given adherence to a protocol is already a major issue [ 14 ], a complex assessment is likely to exacerbate the situation.…”

“…Simply raising awareness of eye care through education of healthcare professionals working in an ICU reduces the rate of EK substantially without any changes to prescribed treatment [ 21 ]. Furthermore, formalised guidelines and protocols, when incorporated in patient care plans, can significantly reduce the rate of EK [ 22 , 23 ].…”

The impact of normal saline on the incidence of exposure keratopathy in patients hospitalized in intensive care units

“…[ 4 5 ] The prevalence of eye disorders has been reported as 3.6%–60% in different studies. [ 6 7 ] The difference in the prevalence of keratopathy reported in previous studies is due to the different assessment methods used. [ 2 ] Corneal damage may occur at any time;[ 4 ] however, its highest prevalence is observed during day 2–7 of hospitalization.…”

Effects of HGF and KGF gene silencing on vascular endothelial growth factor and its receptors in rat ultraviolet radiation‑induced corneal neovascularization

“…HGF acts by binding to a specific receptor, c-Met, and is reported to promote keratinocyte proliferation and stimulate keratinocyte metalloproteinase production in response to skin injury, migration and proliferation (35). An intact corneal epithelium is essential for maintaining vision and protecting against infection (36). Healing of epithelial wounds in a healthy cornea occurs relatively fast (20).…”