Exposure keratopathy in sedated and ventilated patients

Abstract Purpose The purpose of this study is to determine the frequency of exposure keratopathy in sedated/mechanically ventilated patients in the intensive care unit and its risk factors. Materials and Methods This is a prospective cohort study including all patients admitted to an adult intensive...

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Bibliographic Details
Published in:Journal of critical care 2012-12, Vol.27 (6), p.537-541
Main Authors: Jammal, Hisham, FRCSEd, Khader, Yousef, PhD, Shihadeh, Wisam, MD, Ababneh, Laila, MBBS, AlJizawi, Ghazal, MBBS, AlQasem, Arqam, MBBS
Format: Article
Language:English
Subjects:
Adult
Age Factors
Aged
Anesthesia
Chemosis
Critical Care
Deep Sedation
Exposure
Female
Hospitals
Humans
Intensive care
Intensive Care Units
Jordan
Keratitis - etiology
Keratopathy
Lagophthalmos
Length of Stay
Male
Middle Aged
Patients
Prospective Studies
Respiration, Artificial - adverse effects
Risk Factors
Sedated
Sex Factors
Statistical analysis
Studies
Time Factors
Ventilation
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Summary:Abstract Purpose The purpose of this study is to determine the frequency of exposure keratopathy in sedated/mechanically ventilated patients in the intensive care unit and its risk factors. Materials and Methods This is a prospective cohort study including all patients admitted to an adult intensive care unit department between March and October 2010 who were sedated and mechanically ventilated. Patients were examined by an ophthalmologist 1 to 5 days after commencing ventilation and subsequently every day. Examination included assessment of lid position, conjunctival edema (chemosis), and corneal changes. Results Of the 74 patients included in the study, 57% had exposure keratopathy. Fifty-four percent of patients developed chemosis, and 31% of patients developed lagophthalmos. Frequency of exposure keratopathy differed significantly according to degree of chemosis and lagophthalmos ( P < .0001); lagophthalmos was also significantly related to chemosis ( P < .0001). For lagophthalmos score of 3, the odds ratio of association with higher exposure keratopathy score was 136 (95% confidence interval [CI], 14.97-1242.6); for lagophthalmos score of 2, it was 14.4 (95% CI, 2.67-77.2). For any edema, the odds ratio of association with exposure keratopathy was 5.50 (95% CI, 2.02-15.00). Conclusion The frequency of exposure keratopathy in sedated/mechanically ventilated patients is high with lagophthalmos and chemosis as the main risk factors.
ISSN:0883-9441
1557-8615
DOI:10.1016/j.jcrc.2012.02.005