Kontakt 2019, 21(2):144-150 | DOI: 10.32725/kont.2019.023

The incidence of complications in comatose patientsNursing - Original article

Mária Šupínová *, Martina Ostrolucká
Slovak Medical University in Bratislava, Faculty of Health in Banská Bystrica, Banská Bystrica, Slovak Republic

Introduction: Coma is a severe state from which the patient may not awaken for weeks, months or years.

Design: A prospective qualitative study based on structured observation.

Objective: The main objective of the study was to identify the incidence of complications in comatose patients. Sample: A total of 22 respondents in a comatose state with an average age of 54.05 years and an average duration of coma of 3.73 years were included in the study.

Methods: The structured observation method was used to carry out the research. Interval coding of predefined categories of complications was used, with an interval of every 30 days within one year.

Results: A closer relationship between the respondents' sex and the incidence of complications was demonstrated (p = 0.05); conjunctivitis (p = -0.46); inflammation around two-way catheter (p = -0.57); pneumonia (p = -0.53); intertrigo (p = -0.44) and decubitus (p = -0.48). A statistical association between respondents' BMI and the incidence of diarrhea (p = -0.55) and BMI/constipation (p = -0.78) was proven throughout the sample. Significance was not proven between the incidence of complications and respondents' age, not even in relation to the duration of comatose state.

Conclusions: The results of the research have proven that the incidence of the complications monitored in the sample of comatose patients is neither independent of their age nor duration of the comatose state. A closer relationship between the respondents' sex and the incidence of certain complications was demonstrated. Identifying the complications of this condition and the specificities of very demanding nursing care can be beneficial in providing quality nursing care for comatose patients.

Keywords: Comatose patient; Comatose state; Complications; Nursing care

Received: August 30, 2018; Accepted: February 1, 2019; Prepublished online: April 15, 2019; Published: June 17, 2019  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Šupínová M, Ostrolucká M. The incidence of complications in comatose patients. Kontakt. 2019;21(2):144-150. doi: 10.32725/kont.2019.023.
Download citation

References

  1. Álvarez-Lerma F, Palomar-Martínez M, Sánchez-García M, Martínez-Alonso M, Álvarez-Rodríguez J, Lorente L (2018). Prevention of ventilator-associated pneumonia: The multimodal approach of the spanish icu "pneumonia zero" program. Crit Care Med 46(2): 181-188. DOI: 10.1097/CCM.0000000000002736. Go to original source... Go to PubMed...
  2. Bender A, Jox RJ, Grill E, Straube A, Lulé D (2015). Persistent vegetative state and minimally conscious state: a systematic review and meta-analysis of diagnostic procedures. Dtsch Arztebl Int 112(14): 235-242. DOI: 10.3238/arztebl.2015.0235. Go to original source... Go to PubMed...
  3. Bonsignore LT, Macrì S, Orsi P, Chiarotti F, Alleva E (2014). Coma and vegetative states: state of the art and proposal of a novel approach combining existing coma scales. Ann 1st Super Sanita 50(3): 241-248. DOI: 10.4415/ANN_14_03_07. Go to original source... Go to PubMed...
  4. Burns KE, McLaren A (2008). A critical review of thromboembolic complications associated with central venous catheters. Can J Anesth 55(8): 532-541. DOI: 10.1007/BF03016674. Go to original source... Go to PubMed...
  5. Chlan LL, Heiderscheit A, Skaar DJ, Neidecker MV (2018). Economic evaluation of a patient-directed music intervention for ICU patients receiving mechanical ventilatory support critical care medicine 46(9): 1430-1435. DOI: 10.1097/CCM.0000000000003199. Go to original source... Go to PubMed...
  6. Dincer M, Doger C, Sen Tas S, Karakaya D (2018). An analysis of patients in palliative care with pressure injuries. Niger J Clin Pract 21(4): 484-491. DOI: 10.4103/njcp.njcp_51_17. Go to original source... Go to PubMed...
  7. Doležil D, Carbolová K (2007). Vegetativní stav (Apalický syndrom). Neurol pro Praxi 1: 27-31.
  8. Drábková J (2001). Mozek - Alfa a omega života. Zdravotnické noviny. 2001-6-7. [online] [cit. 2016-03-02]. Available from: http://zdravi.euro.cz/clanek/mozek-alfa-a-omega-zivota
  9. Estraneo A, Loreto V, Masotta Psy O, Pascarella A, Trojano L (2018). Do medical complications impact long-term outcomes in prolonged disorders of consciousness? Arch Phys Med Rehabil 99(12): 2523-2531. DOI: 10.1016/j.apmr.2018.04.024. Go to original source... Go to PubMed...
  10. Firment J (2009). Aj pacient ktorý sa preberie z kómy môže žiť bez následkov. Korzár. [online] [cit. 2016-06-23]. Available from: https://kosice.korzar.sme.sk/c/4405975/aj-pacient-ktory-sa-preberie-z-komy-moze-zit-bez-nasledkov-tvrdi-prednosta-kliniky-aim-vo-fnlp-mudr-jozef-firment.html
  11. Friedlová K (2008). Bazálna stimulácia v ošetrovateľské pěči. Skriptum. Frýdek-Místek: Institut bazálni stimulace.
  12. Haškovcová H (2007). Thanatologie: Náuka o umíraní a smrti. Praha: Galén.
  13. Imanaka H, Taenaka N, Nakamura J, Aoyama K, Hosotani H (1997). Ocular surface disorders in the critically ill. Anesth Analg 85(2): 343-346. Go to original source... Go to PubMed...
  14. Koenig SM, Truwit JD (2006). Ventilator-associated pneumonia: diagnosis, treatment, and prevention. Clin Microbiol Rev 19(4): 637-657. DOI: 10.1128/CMR.00051-05. Go to original source... Go to PubMed...
  15. Krajčík Š, Bajanová E (2012). Dekubity prevencia a liečba v praxi. Bratislava: Herba.
  16. Kubina M, Tanušková D (2015). Mykoplazmová mukozitída a konjunktivitída. Pediatr Prax 16(6): 261-262.
  17. Lančaričová D, Frantová M (2014). Uzatvorené systémy vyšší štandard ošetrovania. Sestra 13(1-2): 32-34.
  18. Langšádl L (2013). Močové infekcie spojené s dlhodobým cievkovaním. Sestra 7(1-2): 27-28.
  19. Lascarrou JB, Lissonde F, Le Thuaut A, Bachoumas K, Colin G, Henry Lagarrigue M, et al. (2017). Antibiotic therapy in comatose mechanically ventilated patients following aspiration: differentiating pneumonia from pneumonitis. Crit Care Med 45(8): 1268-1275. DOI: 10.1097/CCM.0000000000002525. Go to original source... Go to PubMed...
  20. Macková A (2013). Monitoring dekubitov. Sestra 12(1-2): 15.
  21. Miertová M, Kurča E, Tomagová M, et al. (2015). Ošetrovateľstvo v neurológii. [online] [cit. 2016-07-09]. Available from: http://osevneu.jfmed.uniba.sk/
  22. Opavská V (2001). Pohled sestry na apalický syndrom. Pediatr pro Praxi 4: 195-197.
  23. Puggina AC, Paes da Silva MJ, Schnakers C, Laureys S (2012). Nursing care of patients with disorders of consciousness. J Neurosci Nurs 44(5): 260-270. DOI: 10.1097/JNN.0b013e3182666407. Go to original source... Go to PubMed...
  24. Sabolčáková T (2013). Špecifiká enterálnej výživy v intenzívnej medicíe. Sestra 12(3-4): 42-43.
  25. Ševčík P, Černý V, Vítovec J, et al. (2000). Intenzivní medicína. Praha: Galén.
  26. Škutchanová A, Minárik M (2014). Súčasný pohľad na chronické poruchy vedomia. Anestéziol Intenzívna Med 3(2): 50-53.
  27. Snyders O, Khondowe O, Bel J (2011). Oral chlorhexidine in the prevention of ventilator-associated pneumonia in critically ill adults in the ICU: A systematic review. SAJCC Care 27(2): 48-56.
  28. Sorce LR, Hamilton SM, Gauvreau K, Mets MB, Hunter DG, Rahmani B (2009). Preventing corneal abrasions in critically ill children receiving neuromuscular blockade: a randomized, controlled trial. Pediatr Crit Care Med 10(2): 171-175. DOI: 10.1097/PCC.0b013e3181956ccf. Go to original source... Go to PubMed...
  29. Stevens RD, Bhardwaj A (2006). Approach to the comatose patient. Crit Care Med 34(1): 31-41. DOI: 10.1097/01.CCM.0000194534.42661.9F. Go to original source... Go to PubMed...

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.