title: Preventing facial pressure ulcers in patients under non-invasive mechanical ventilation: a randomised control trial.
abstract: OBJECTIVE
  To comparatively assess the efficacy of four different therapeutic strategies to prevent the development of facial pressure ulcers (FPUs) related to the use of non-invasive mechanical ventilation (NIV) with oro-nasal masks in critically ill hospitalised patients.
  
  
  METHODS
  This randomised control trial was performed at the high dependency unit in the University General Hospital Gregorio Marañón in Madrid, Spain. Overall, 152 patients with acute respiratory failure were recruited. All patients were hospitalised and received NIV through oro-nasal masks. The Norton tool was used to evaluate the general risk of developing pressure ulcers (PUs). Subjects were divided into four groups, each of them receiving a different treatment. Tissue assessment and preventive care were performed by a member of the research team.
  
  
  RESULTS
  The incidence of FPUs was significantly lower in the group receiving a solution of hyperoxygenated fatty acids (HOFA) when compared with each of the other therapeutic strategies: direct mask (p=0.055), adhesive thin dressing (p=0.03) and adhesive foam dressing (p<0.001).
  
  
  CONCLUSIONS
  The application of HOFA on the facial skin in contact with the oro-nasal masks showed the highest efficacy in the prevention of NIV-related FPUs.
authors.affiliation: Professor, University General Hospital Gregorio Marañón; Gregorio Marañón Healthcare Research Institute-Nursing Department (IiSGM); Centre for Health Sciences San Rafael-Antonio Nebrija University, Madrid, Spain.
authors.forename: D Peña
authors.initials: DP
authors.lastname: Otero
authors.affiliation: University General Hospital Gregorio Marañón, Madrid, Spain.
authors.forename: D Vazquez
authors.initials: DV
authors.lastname: Domínguez
authors.affiliation: University General Hospital Gregorio Marañón, Madrid, Spain.
authors.forename: L Hernanz
authors.initials: LH
authors.lastname: Fernández
authors.affiliation: Director Nursing Department, University General Hospital Puerta de Hierro, Madrid, Spain.
authors.forename: A Santano
authors.initials: AS
authors.lastname: Magariño
authors.affiliation: University General Hospital Gregorio Marañón, Madrid, Spain.
authors.forename: V Jimenez
authors.initials: VJ
authors.lastname: González
authors.affiliation: Professor, General Hospital San Carlos; Complutense University, Madrid, Spain.
authors.forename: J V García
authors.initials: JV
authors.lastname: Klepzing
authors.affiliation: Director, Professor, Clinic Complutense University; Complutense University, Madrid, Spain.
authors.forename: J V Beneit
authors.initials: JV
authors.lastname: Montesinos
mesh_terms: D000328:Adult; D005145:Face; D005148:Facial Dermatoses / Q000517:prevention & control*; D005227:Fatty Acids / Q000627:therapeutic use*; D005260:Female; D006260:Head Protective Devices / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008397:Masks / Q000009:adverse effects; D008875:Middle Aged; D063087:Noninvasive Ventilation / Q000009:adverse effects* / Q000379:methods; D003668:Pressure Ulcer / Q000209:etiology / Q000517:prevention & control*; D012121:Respiration, Artificial / Q000009:adverse effects; D012128:Respiratory Distress Syndrome / Q000628:therapy; D013030:Spain
chemical_list: D005227:Fatty Acids
keywords: critical patients; facial pressure ulcer; non-invasive medical ventilation; randomised control trial