title: A pilot randomised controlled trial comparing reactive air and active alternating pressure mattresses in the prevention and treatment of pressure ulcers among medical ICU patients.
abstract: BACKGROUND
  Data on the prevention and treatment of pressure ulcers (PU's) among ICU patients is sparse.
  
  
  OBJECTIVE
  To compare PU outcomes in medial ICU patients nursed on either a reactive mattress overlay (ROHO, ROHO Inc, Belleville, IL, USA) or an active alternating pressure mattress (NIMBUS3, ArjoHuntleigh, Luton Bedfordshire, UK).
  
  
  METHODS
  Pilot prospective single blind randomised controlled clinical trial.
  
  
  METHODS
  Two types of pressure redistributing mattress.
  
  
  METHODS
  Two groups of eight patients.
  
  
  METHODS
  Patients included in the study were those at high risk (Norton scale <8) or with a PU on admission.
  
  
  RESULTS
  The two groups had similar patient characteristics. However, the NIMBUS 3 group presented with more ulcers per patient on admission (62.5%) and more severe ulcers (20% category 3) while four patients (50%) presented with a single superficial ulcer in the ROHO group. HEALING: The progress of the ulcers showed significant decreases in PU surface area (p=0.05), total PUSH tool score (p=0.01) in the NIMBUS 3 group compared to the ROHO group. In the NIMBUS 3 group 82% of the ulcers improved versus none in the ROHO group (p=0.002) and 18% remained stable versus 33%. None of the ulcers deteriorated in the NIMBUS 3 group versus 67% in the ROHO group (p=0.006). Full thickness wounds (Category 3) were present in 22% of the NIMBUS 3 group versus 0% of the ROHO group on admission and in 0% versus 66.7% (p=0.008) respectively at the end of the pilot study.
  
  
  CONCLUSIONS
  Non-blanching erythema occurred equally in both arms at baseline; skin remained intact for the NIMBUS 3 group while 50% in the ROHO group worsened with superficial tissue loss.
  
  
  CONCLUSIONS
  This small pilot study suggests that 'active' alternating therapy is a useful adjunct in the care of highly vulnerable patients, while the outcomes may be less favourable when using 'reactive', constant low pressure devices.
authors.affiliation: Intensive Care Unit, ZiekenhuisNetwerk Antwerpen, Campus Stuivenberg, Lange Beeldekensstraat 267, B-2060 Antwerpen 6, Belgium. manu.malbrain@skynet.be
authors.forename: Manu
authors.initials: M
authors.lastname: Malbrain
authors.forename: Bart
authors.initials: B
authors.lastname: Hendriks
authors.forename: Patricia
authors.initials: P
authors.lastname: Wijnands
authors.forename: Dirk
authors.initials: D
authors.lastname: Denie
authors.forename: Anita
authors.initials: A
authors.lastname: Jans
authors.forename: Jef
authors.initials: J
authors.lastname: Vanpellicom
authors.forename: Bart
authors.initials: B
authors.lastname: De Keulenaer
mesh_terms: D000368:Aged; D000399:Air Pressure; D001513:Beds / Q000592:standards*; D001530:Belgium; D015400:Clinical Nursing Research; D003422:Critical Care; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment; D056888:Patient Positioning; D010865:Pilot Projects; D003668:Pressure Ulcer / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D016037:Single-Blind Method; D016896:Treatment Outcome; D014945:Wound Healing