| Summary: | 碩士 === 國立臺灣大學 === 護理學研究所 === 102 === Background: Critically ill patients in the ICU are in an altered state of consciousness due to disease or sedative treatment and have a reduced ability for corneal protection, leading to an increased risk of corneal abrasion.
Objective: The incidence rate and risk factor correlation of corneal abrasion in critically ill patients will be examined.
Methods: A total of 93 critically ill patients admitted to the ICU in one hospital from June 2013 to June 2014 were screened twice a week by using a cobalt blue light and 2% fluorescein solution. Observational methods and collected structured patient data (condition of corneal abrasion and personal data of patients) were analyzed.
Results: Out of a total of 93 patients, corneal abrasion occurred in 25 (26.9%). The mean time for development of abrasion after admission to ICU was 12.8 days, and risk factors for corneal abrasion were the following: (1) Glasgow coma scale (GCS) score of 7 or lower at time of admission (χ^2=14.13, P<0.001), (2) Richmond agitation-sedation scale (RASS) score from- 1 to -4 (χ^2=30.64, P<0.001), (3) insufficient ability to close eyes (χ^2=20.22, P<0.001), (4) a gap between upper and lower eyelids when eyes are closed (χ^2=16.75, P<0.001), (5) use of sedatives (χ^2=7.90, P<0.05), and (6) use of muscle relaxants (χ^2=5.17, P<0.05). A logistic regression analysis showed RASS and gap between the eyelids when closing the eyes are predictors of corneal abrasion.
Conclusions: Corneal abrasion occurs in over a quarter of critically ill patients who use a ventilator longer than 24 hours, showing that the use of simple tools has notable observable effects on detecting abrasion early. Based on follow-up observations, early detection and treatment of corneal abrasion can lead to faster recovery.
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