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Araújo JNDM, Fernandes APNDL, Dantas AC, Ferreira MA, Lopes MVDO, Vitor AF. Ocular dryness in intensive care: proposal for a new nursing diagnosis. Rev Bras Enferm 2023; 76Suppl 4:e20220698. [PMID: 37971054 PMCID: PMC10642012 DOI: 10.1590/0034-7167-2022-0698] [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: 06/28/2022] [Accepted: 03/27/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE to analyze the concept associated with diagnostic proposition Ocular dryness in adult patients hospitalized in an Intensive Care Unit, identifying its attributes, antecedents and consequences. METHODS a methodological study carried out through concept analysis, operationalized by scoping review. RESULTS the analysis of 180 studies allowed the identification of two attributes, 32 antecedents and 12 consequences. The attributes were tear film deficiency and ocular signs and/or symptoms. The prevalent antecedents were incomplete eyelid closure (lagophthalmos) and blinking mechanism decrease. Major consequences included conjunctival hyperemia and decreased tear volume. CONCLUSIONS this study allowed constructing nursing diagnosis Ocular dryness, part of domain 11, class 2, with 12 defining characteristics, 12 related factors, seven populations at risk and 13 associated conditions. This problem-focused proposal may provide targeted care by promoting early detection and implementing interventions that reduce the risk of ocular damage.
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Affiliation(s)
| | | | - Ana Clara Dantas
- Universidade Federal do Rio Grande do Norte. Natal, Rio Grande do Norte, Brazil
| | | | | | - Allyne Fortes Vitor
- Universidade Federal do Rio Grande do Norte. Natal, Rio Grande do Norte, Brazil
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2
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Exposure keratopathy in patients undergoing invasive ventilation: Prevalence, severity, and the role of surface lubrication. Ocul Surf 2022; 25:55-57. [DOI: 10.1016/j.jtos.2022.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 11/15/2022]
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Wang L, Deng Y. Comment on "Ocular Manifestations of Hospitalized Patients with COVID-19 in Northeast of Iran". Ocul Immunol Inflamm 2021; 29:697. [PMID: 33974480 DOI: 10.1080/09273948.2021.1903939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Lixiang Wang
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Yingping Deng
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
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Simkiene J, Pranskuniene Z, Vitkauskiene A, Pilvinis V, Boerma EC, Pranskunas A. Ocular microvascular changes in patients with sepsis: a prospective observational study. Ann Intensive Care 2020; 10:38. [PMID: 32266602 PMCID: PMC7138894 DOI: 10.1186/s13613-020-00655-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/24/2020] [Indexed: 12/11/2022] Open
Abstract
Background The aim of the study was to detect differences in the conjunctival microcirculation between septic patients and healthy subjects and to evaluate the course of conjunctival and retinal microvasculature in survivors and non-survivors over a 24-h period of time. Methods This single-center prospective observational study was performed in mixed ICU in a tertiary teaching hospital. We included patients with sepsis or septic shock within the first 24 h after ICU admission. Conjunctival imaging, using an IDF video microscope, and retinal imaging, using portable digital fundus camera, as well as systemic hemodynamic measurements, were performed at three time points: at baseline, 6 h and 24 h. Baseline conjunctival microcirculatory parameters were compared with healthy controls. Results A total of 48 patients were included in the final assessment and analysis. Median APACHE II and SOFA scores were 16[12–21] and 10[7–12], respectively. Forty-four (92%) patients were in septic shock, 48 (100%) required mechanical ventilation. 19 (40%) patients were discharged alive from the intensive care unit. We found significant reductions in all microcirculatory parameters in the conjunctiva when comparing septic and healthy subjects. In addition, we observed a significant lower microvascular flow index (MFI) of small conjunctival vessels during all three time points in non-survivors compared with survivors. However, retinal arteriolar vessels were not different between survivors and non-survivors. Conclusions Conjunctival microvascular blood flow was altered in septic patients. In the 24-h observation period conjunctival small vessels had a significantly higher MFI, but no difference in retinal arteriolar diameter in survivors in comparison with non-survivors. Trial registration NCT04214743, https://www.clinicaltrials.gov. Date of registration: 31 December 2019 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04214743
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Affiliation(s)
- Jurate Simkiene
- Department of Intensive Care Medicine, Lithuanian University of Health Sciences, Eiveniu str. 2, Kaunas, 50009, Lithuania
| | - Zivile Pranskuniene
- Department of Drug Technology and Social Pharmacy, Lithuanian University of Health Sciences, Eiveniu str. 2, Kaunas, 50009, Lithuania.,Institute of Pharmaceutical Technologies, Lithuanian University of Health Sciences, Eiveniu str. 2, Kaunas, 50009, Lithuania
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Lithuanian University of Health Sciences, Eiveniu str. 2, Kaunas, 50009, Lithuania
| | - Vidas Pilvinis
- Department of Intensive Care Medicine, Lithuanian University of Health Sciences, Eiveniu str. 2, Kaunas, 50009, Lithuania
| | - E Christiaan Boerma
- Department of Intensive Care Medicine, Medical Center Leeuwarden, Henri Dunantweg 2, 8901 BR, Leeuwarden, The Netherlands
| | - Andrius Pranskunas
- Department of Intensive Care Medicine, Lithuanian University of Health Sciences, Eiveniu str. 2, Kaunas, 50009, Lithuania.
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Araújo MGD, Vitor AF, Silva ABD, Carvalho LMD, Alves DLBDS, Araújo JNDM. Validation of nursing outcome indicators of the nursing outcomes classification: dry eye severity. Rev Bras Enferm 2020; 73:e20190854. [DOI: 10.1590/0034-7167-2019-0854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/26/2020] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: To validate the content of the indicators of the nursing outcome Dry eye severity, of the Nursing Outcomes Classification, in adult patients admitted to the intensive care unit. Methods: Methodological study of content validity, developed in two stages: the first, consisting of 23 specialists; and the second, of a consensus group formed by ten nurses. For analyzing the data in the first stage, we used the content validity index and binomial test for each indicator; in the second stage, the discussions of each meeting were transcripted, and the indicators that achieved 100% consensus were validated. Results: Of the 14 indicators evaluated by the specialists, 7 presented a cut-off point below 0.80, but did not show statistical significance in the binomial test. In the consensus group’s validation, six indicators were reformulated. Conclusion: This study considered the 14 indicators valid for evaluating patients admitted to the intensive care unit.
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Soares RPDS, Fernandes APNDL, Botarelli FR, Araújo JNDM, Olímpio JDA, Vitor AF. Clinical indicators of dry eye severity nursing outcome in intensive care unit. Rev Lat Am Enfermagem 2019; 27:e3201. [PMID: 31664409 PMCID: PMC6818663 DOI: 10.1590/1518-8345.2983.3201] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 06/29/2019] [Indexed: 11/26/2022] Open
Abstract
Objective: to verify the extent of impairment of the clinical indicators of the nursing outcome Dry Eye Severity in patients admitted to the Intensive Care Unit. Method: cross-sectional, descriptive study developed with 206 patients. Based on the result listed, six indicators of the Classification of Nursing Results were evaluated with a questionnaire containing clinical variables and the Likert scale of the Classification of Nursing Results with constructed definitions, which varies from more impaired to non-impaired. The data were analyzed using descriptive and inferential statistics. Results: the decrease in lacrimal production and the presence of redness in the conjunctiva were more impaired. The other indicators were more frequent for the absence of impairment: incomplete eyelid closure 81% (167), excessive tearing 95.1%(196), excessive mucous secretion 78.7% (162) and decreased blinking mechanism 50.5% (104). The clinical characteristics of hospitalization for neurological disorders, invasive mechanical ventilation, chemosis, use of sedatives, vasoconstrictors, benzodiazepines, antibiotics and corticosteroids interfered in the impairment of the dry eye severity. Conclusion: the result indicators show that the clinical characteristics of patients in the intensive care unit interfere in the impairment and in the dry eyes severity. According to these results, the importance of assistance directed to the prevention of eye diseases is emphasized.
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Affiliation(s)
- Raffaela Patrícia da Silva Soares
- Universidade Federal do Rio Grande do Norte, Departamento de Enfermagem, Natal, RN, Brazil.,Secretaria Municipal de Saúde, Unidade de Pronto Atendimento Dr. Luiz Lindbergh Farias, João Pessoa, PB, Brazil
| | - Ana Paula Nunes de Lima Fernandes
- Universidade Federal do Rio Grande do Norte, Departamento de Enfermagem, Natal, RN, Brazil.,Scholarship holder at the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | | | | | | | - Allyne Fortes Vitor
- Universidade Federal do Rio Grande do Norte, Departamento de Enfermagem, Natal, RN, Brazil
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Araújo JNDM, Botarelli FR, Fernandes APNDL, Oliveira-Kumakura ARDS, Ferreira Júnior MA, Vitor AF. Predictive clinical factors for ocular dryness in patients admitted to the Intensive Care Unit. Rev Esc Enferm USP 2019; 53:e03493. [PMID: 31389488 DOI: 10.1590/s1980-220x2018036603493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 11/21/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the predictive clinical factors for ocular dryness and for the nursing diagnosis Risk for dry eye in the ocular surface of hospitalized adult patients in an intensive care unit. METHOD A cross-sectional study was conducted between January and July 2016, with 206 patients (412 eyes). An inference about the presence of the diagnosis in the evaluated patients was performed by diagnostic nurses. The descriptive and inferential statistics subsidized the data analysis. RESULTS 47.6% of the patients presented Risk for dry eye, and 52.4% were already diagnosed with ocular dryness. Statistical differences between the ocular dryness diagnosis in the right eye with hyperemia, mucous secretion, eyelid edema and lagophthalmia were identified. In addition, statistical differences were observed between hyperemia and eyelid edema with Risk for dry eye in the left eye and with the nursing diagnosis Risk for dry eye. CONCLUSION Hyperemia, mucous secretion, eyelid edema and lagophthalmia are the predictive clinical factors for the nursing diagnosis Risk for dry eye and also of ocular dryness in the intensive care unit environment which deserve special attention in the preventive evaluation.
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Affiliation(s)
- Jéssica Naiara de Medeiros Araújo
- Universidade Federal do Rio Grande do Norte , Departamento de Enfermagem , Programa de Pós-Graduação em Enfermagem , Natal , RN , Brasil
| | - Fabiane Rocha Botarelli
- Universidade Federal do Rio Grande do Norte , Departamento de Enfermagem , Natal , RN , Brasil
| | - Ana Paula Nunes de Lima Fernandes
- Universidade Federal do Rio Grande do Norte , Departamento de Enfermagem , Programa de Pós-Graduação em Enfermagem , Natal , RN , Brasil
| | | | | | - Allyne Fortes Vitor
- Universidade Federal do Rio Grande do Norte , Departamento de Enfermagem , Programa de Pós-Graduação em Enfermagem , Natal , RN , Brasil
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de Araujo DD, Silva DVA, Rodrigues CAO, Silva PO, Macieira TGR, Chianca TCM. Effectiveness of Nursing Interventions to Prevent Dry Eye in Critically Ill Patients. Am J Crit Care 2019; 28:299-306. [PMID: 31263013 DOI: 10.4037/ajcc2019360] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Critically ill patients are susceptible to the development of dry eye. Few studies have been conducted on how to best prevent and treat this condition. OBJECTIVE To compare the effectiveness of 2 nursing interventions in preventing dry eye in adult intensive care unit patients: liquid artificial tears (Lacribell; Latinofarma) and artificial tears gel (Vidisic Gel; Bausch and Lomb). METHODS In this randomized controlled trial, 140 participants were randomly assigned to 1 of 2 treatment groups: a liquid artificial tears group (n = 70) and an artificial tears gel group (n = 70). The study inclusion criteria were as follows: admission to the intensive care unit, age of 18 years or older, no diagnosis of dry eye at admission, receipt of mechanical ventilation, blink rate of less than 5 times per minute, and a score of 7 or less on the Glasgow Coma Scale. On 5 consecutive days, a single researcher who was unaware of the treatment assignment assessed the participants' eyes using the fluorescein eye stain test and the Schirmer test for dry eye. RESULTS Dry eye developed in 21% of participants who received liquid artificial tears versus 9% of participants who received artificial tears gel (P = .04). CONCLUSIONS In this study, artificial tears gel was superior to liquid artificial tears in preventing the development of dry eye. These results may help nurses deliver evidence-based eye care aimed at reducing the risk of dry eye in critically ill patients.
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Affiliation(s)
- Diego Dias de Araujo
- Diego Dias de Araujo is assistant professor and Daniel Vinicius Alves Silva, Carolina Amaral Oliveira Rodrigues, and Patricia Oliveira Silva are undergraduate students, Department of Nursing, Universidade Estadual de Montes Claros, Montes Claros, Brazil. Tamara Goncalves Rezende Macieira is a PhD candidate, College of Nursing, University of Florida, Gainesville, Florida. Tania Couto Machado Chianca is professor, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Daniel Vinicius Alves Silva
- Diego Dias de Araujo is assistant professor and Daniel Vinicius Alves Silva, Carolina Amaral Oliveira Rodrigues, and Patricia Oliveira Silva are undergraduate students, Department of Nursing, Universidade Estadual de Montes Claros, Montes Claros, Brazil. Tamara Goncalves Rezende Macieira is a PhD candidate, College of Nursing, University of Florida, Gainesville, Florida. Tania Couto Machado Chianca is professor, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Carolina Amaral Oliveira Rodrigues
- Diego Dias de Araujo is assistant professor and Daniel Vinicius Alves Silva, Carolina Amaral Oliveira Rodrigues, and Patricia Oliveira Silva are undergraduate students, Department of Nursing, Universidade Estadual de Montes Claros, Montes Claros, Brazil. Tamara Goncalves Rezende Macieira is a PhD candidate, College of Nursing, University of Florida, Gainesville, Florida. Tania Couto Machado Chianca is professor, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Patricia Oliveira Silva
- Diego Dias de Araujo is assistant professor and Daniel Vinicius Alves Silva, Carolina Amaral Oliveira Rodrigues, and Patricia Oliveira Silva are undergraduate students, Department of Nursing, Universidade Estadual de Montes Claros, Montes Claros, Brazil. Tamara Goncalves Rezende Macieira is a PhD candidate, College of Nursing, University of Florida, Gainesville, Florida. Tania Couto Machado Chianca is professor, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Tamara Goncalves Rezende Macieira
- Diego Dias de Araujo is assistant professor and Daniel Vinicius Alves Silva, Carolina Amaral Oliveira Rodrigues, and Patricia Oliveira Silva are undergraduate students, Department of Nursing, Universidade Estadual de Montes Claros, Montes Claros, Brazil. Tamara Goncalves Rezende Macieira is a PhD candidate, College of Nursing, University of Florida, Gainesville, Florida. Tania Couto Machado Chianca is professor, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Tania Couto Machado Chianca
- Diego Dias de Araujo is assistant professor and Daniel Vinicius Alves Silva, Carolina Amaral Oliveira Rodrigues, and Patricia Oliveira Silva are undergraduate students, Department of Nursing, Universidade Estadual de Montes Claros, Montes Claros, Brazil. Tamara Goncalves Rezende Macieira is a PhD candidate, College of Nursing, University of Florida, Gainesville, Florida. Tania Couto Machado Chianca is professor, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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