Úlceras de pressão: um estudo com pacientes de unidade de terapia intensiva

To characterize patients according to gender, age category, internment time, diagnostical hypothesis and location of the pressure ulcer; to identify the susceptibility conditions, intrinsical and extrinsical factors present on ICU patients and to verify on the existence of association between the susceptibility conditions and the intrinsecal and extrinsecal factors on the occurrence of PU. Methods: It is a descriptive study, of longitudinal design of the panel type, with quantitative approach, performed on two ICU s of a private hospital located in Natal/RN, with 40 patients interned at these units. The data collection was performed on all three shifts through a structured observation and physical exam of the patients' skin form seeking to identify the presence of PU. Results: The greatest occurence of PU was on individuals of the male gender (70%) when compared to the female gender (30%), that difference being statistically significant (p=0,0267), with the male gender presenting 4,3 times greater chance of developing PU than the female; the predominant age category was from 60 years of age on (85%), 60,0% presented 1 to 2 PU s after 7 (seven) days of permanence in the ICU s, the predominant diagnostical hypothesis on the patients with PU were the respiratory diseases (42,3%) and the most frequent locations of PU were the sacral region (40,0%) and heels (36,0%). 25 PU s of stage I were diagnosed on 50,0% of the followed patients, with general incidence of 50,0% on both ICUs. from the 88 variables researched, 75 were identified on the patients from the study, being the predominant conditions (anemia, hypotension, leukocytosis, other diseases hypertension blood pressure, cardiac insuffience, pneumonia - and ansiolythic), the intrinsecal factors (diminished muscular strenght and/or mass, discrete edema, totally compromised mobile coordination and total inability for movement on the bed) and the extrinsecal factors (inadequate mattress type, permanence on a single position for >2 hours, shearing/friction force, bed clothes with folds that leave marks on the body, pressure force) predominated on patients with PU. The male gender variables (p=0,0267,OR=4,3), sedation (p=0,0006,OR=4,1), psychomotive agitation (p=0,0375,OR=5,8) and leukocytosis (p=0,0285,OR=5,0) presented a significant statistical diference when analyzed independently. We verified an association of 17,3%, statistically significant (p=0,0384), between the susceptibility conditions (anemia, leukocytosis and hypotension), the intrinsecal factors (age equal or above 60 years, diminished/absent pain sensibility and smooth, fine or delicate skin) and the extrinsecal factors (inadequate mattress, pressure forces, shearing/friction force, permanence on a single position for more than 2 hours, elevation between 30 to 45 degrees and inadequate bed clothes' conditions), with a chance ratio of 4,6 times the risk of occurrence of PU on the patients that presented the referred association. Conclusion: The incidence of PU detected on the ICU-interned patients was high and we made evident the existence of association between the susceptibility conditions, the intrinsecal and extrinsecal factors on the occurrence of PU s on the ICUinterned patients, and thus we accept the alternative hypothesis proposed on the study

Análise tribológica de um sistema de acionamento alternativo de pigs para a indústria do petróleo

It is analyzed through the concepts of tribology and mechanical contact and damage the suggestion of implementing a backup system for traction and passage of Pipeline Inspection Gauge (Pig) from the inside of pipelines. In order to verify the integrity of the pipelines, it is suggested the possibility of displacement of such equipment by pulling wires with steel wires. The physical and mechanical characteristics of this method were verified by accelerated tests in the laboratory in a tribological pair, wire versus a curve 90. It also considered the main mechanisms of wear of a sliding system with and without lubricant, in the absence and presence of contaminants. To try this, It was constructed a test bench able to reproduce a slip system, work on mode back-and-forth ("reciprocation"). It was used two kinds of wires, a galvanized steel and other stainless steel and the results achieved using the two kinds of steel cables were compared. For result comparative means, it was used steel cables with and without coating of Poly Vinyl Chloride (PVC). The wires and the curves of the products were characterized using metallographic analysis, microhardness Vickers tests, X-ray diffraction (XRD), X-Ray Refraction (XRF) and tensile tests. After the experiments were analyzed some parameters that have been measurable, it demonstrates to the impracticality of this proposed method, since the friction force and the concept of alternating request at the contact between the strands of wire and the inner curves that are part ducts caused severe wear. These types of wear are likely to cause possible failures in future products and cause fluid leaks