The use of indicators of the regeneration of decubital ulcers in a comprehensive assessment of the nutritional status of patients in a chronic critical illness
| Autor: | Kirill M. Gorshkov, Jel'han G. Osmanov, Alexandr E. Shestopalov, Alexandra V. Yakovleva, Alexey A. Yakovlev, Alexandr M. Shulutko, Evgenij L. Altuhov, Inessa G. Shchelkunova, Elena G. Gandybina |
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| Rok vydání: | 2020 |
| Předmět: | |
| Zdroj: | Medical and Social Expert Evaluation and Rehabilitation. 23:63-68 |
| ISSN: | 2412-2092 1560-9537 |
| DOI: | 10.17816/mser34280 |
| Popis: | Background: Thanks to advances in emergency medical and surgical care, the number of patients experiencing acute critical illnesses is increasing. However, a group of patients in the so-called chronic critical illness (CCI) was formed. In this category of patients, the problem of treating decubital ulcers is relevant, since they are characterized by a combination of prolonged immobilization, severe protein catabolism, neuroendocrine and metabolic disorders, protein-energy malnutrition (PEN) and tissue trophic disorders. Aims: Analyze the correlation of the degree of regeneration of decubital ulcers according to the Bates-Jenson scale in the modification S.Y.R. in relation to indicators of the nutritional status of patients in the CCI after brain damage. Materials and methods: The study included 26 patients with pressure ulcers II, III, IV stage with PEN. To evaluate decubital ulcers, the adapted Bates-Jensen scale in the S.Y.R. modification was used. (with graphic model). The severity of PEN was evaluated by a complex of anthropometric (BMI, shoulder circumference, thickness of the skin-fat fold, circumference of the shoulder muscles) and laboratory (transferrin, absolute lymphocyte count) indicators. The dynamics of anthropometric indicators and the results of laboratory studies were separately considered. Results: As a result, it was found that the change in anthropometric data correlated with laboratory parameters and the healing rate of decubital ulcers in only 26.9% of cases. Moreover, this correlation between the dynamics of transferrin and the absolute number of lymphocytes with the regeneration of decubital ulcers was observed in all patients. The obtained results demonstrated a direct correlation between the dynamics of healing of pressure ulcers and changes in laboratory indicators of nutritional status (as opposed to anthropometry data) in patients who are in a CCI after brain damage. Conclusions: These findings provide an opportunity to review the weight of indicators in assessing the severity of protein-energy malnutrition, as well as introducing the rate of regeneration of a decubital ulcer in the presence of a patient into the assessment of the nutritional status. |
| Databáze: | OpenAIRE |
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