Abstract:

Objective To investigate the characteristics of medical device-related pressure injury (MDRPI) in patients underwent cardiopulmonary bypass, and to analyse its influencing factors. Methods A convenience sampling of 426 patients underwent cardiopulmonary bypass in the Cardiac Surgery Intensive Care Unit of the First Affiliated Hospital of Xinjiang Medical University from June 2023 to April 2024 was conducted. The patients were divided into MDRPI group (n=99) and non-MDRPI group (n=327) based on the presence or absence of MDRPI. Univariate analysis and Lasso regression were used to screen the influencing factors and included in logistic regression analysis. Results MDRPI occurred in 99 (22.2%) cases among the 426 subjects. Logistic regression analysis showed that high intraoperative heparin sodium dosage, emergency surgery, postoperative fever, and long cardiopulmonary bypass time were independent risk factors (all OR>1, P<0.05), and higher nurse level and higher platelet level were protective factors (OR<1, P<0.05). The area under the receiver operating characteristic (ROC) curve (AUC) of model was 0.874 (95%CI: 0.837-0.910), with a sensitivity of 0.828 and a specificity of 0.768. The model discrimination was good, and the Hosmer-Lemeshow (H-L) test (χ²=3.094, P=0.928) had a good fit of the model. Conclusion After cardiopulmonary bypass, patients are prone to MDRPI due to high intraoperative heparin sodium dosage, low platelet level, emergency surgery, postoperative fever, long cardiopulmonary bypass time and low nurse energy level. Clinicians should comprehensively evaluate and give predictive preventive measures to reduce the risk of MDRPI.

Key words: extracorporeal circulation, breathing apparatus, device-related pressure injury, characteristics of occurrence, root cause analysis