{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T12:54:41Z","timestamp":1790168081548,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,2,5]],"date-time":"2023-02-05T00:00:00Z","timestamp":1675555200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The combination of prone positioning and extracorporeal membrane oxygenation (ECMO) in patients with acute respiratory distress syndrome (ARDS) is recognized as safe but its use has been limited due to potential complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To report the prevalence of pressure ulcers and other complications due to prone positioning in adult patients receiving veno\u2013venous ECMO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>\n                      This cross\u2010sectional study was conducted in a tertiary level intensive care unit (ICU) in Milan (Italy), between January 2015 and December 2019. The study population was critically ill adult patients undergoing veno\u2013venous ECMO. Statistical association between pressure ulcers and the type of body positioning (prone\n                      <jats:italic>versus<\/jats:italic>\n                      supine) was explored fitting a logistic model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the study period, 114 patients were treated with veno\u2013venous ECMO and 62 (54.4%) patients were placed prone for a total of 130 prone position cycles. ECMO cannulation was performed via femoro\u2013femoral configuration in the majority of patients (82.4%, 94\/114). Pressure ulcers developed in 57.0% of patients (95%CI: 44.0%\u201372.6%), most often arising on the face and the chin (37.1%, 23\/62), particularly in those placed prone. The main reason of prone positioning interruption was the decrease of ECMO blood flow (8.1%, 5\/62). The fitted model showed no association between body position during ECMO and occurrence of pressure ulcers (OR 1.3, 95%CI: 0.5\u20133.6,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.532).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Facial pressure ulcers were the most frequent complications of prone positioning. Nurses should plan and implement evidence\u2010based care to prevent such pressure injuries in patients undergoing ECMO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>The combination of prone positioning and ECMO shows few life\u2010threating complications. This manoeuvre during ECMO is feasible and safe when performed by experienced ICU staff.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.12889","type":"journal-article","created":{"date-parts":[[2023,2,5]],"date-time":"2023-02-05T22:29:34Z","timestamp":1675636174000},"page":"65-72","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Pressure ulcers after prone positioning in patients undergoing extracorporeal membrane oxygenation: A cross\u2010sectional study"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2937-2698","authenticated-orcid":false,"given":"Filippo","family":"Binda","sequence":"first","affiliation":[{"name":"Department of Healthcare Professions Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"},{"name":"Department of Anesthesia, Intensive Care and Emergency Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4511-7996","authenticated-orcid":false,"given":"Federica","family":"Marelli","sequence":"additional","affiliation":[{"name":"Department of Healthcare Professions Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0085-7015","authenticated-orcid":false,"given":"Alessandro","family":"Galazzi","sequence":"additional","affiliation":[{"name":"Department of Healthcare Professions Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6225-2989","authenticated-orcid":false,"given":"Simone","family":"Gambazza","sequence":"additional","affiliation":[{"name":"Department of Healthcare Professions Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2412-9410","authenticated-orcid":false,"given":"Elisa","family":"Vinci","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Intensive Care and Emergency Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7604-9551","authenticated-orcid":false,"given":"Paola","family":"Roselli","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Intensive Care and Emergency Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9720-471X","authenticated-orcid":false,"given":"Ileana","family":"Adamini","sequence":"additional","affiliation":[{"name":"Department of Healthcare Professions Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"},{"name":"Department of Anesthesia, Intensive Care and Emergency Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8552-2630","authenticated-orcid":false,"given":"Dario","family":"Laquintana","sequence":"additional","affiliation":[{"name":"Department of Healthcare Professions Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,5]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-014-3500-8"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/472136"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1214103"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1614"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2018.06.030"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-021-06604-x"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.5301\/ijao.5000254"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.03882"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/nicc.12842"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cnur.2013.11.003"},{"key":"e_1_2_13_12_1","unstructured":"European Pressure Ulcer Advisory Panel National Pressure Injury Advisory Panel Pan Pacific Pressure Injury Alliance.Prevention and Treatment of Pressure Ulcers\/Injuries: Clinical Practice Guideline. The International Guideline. EPUAP\/NPIAP\/PPPIA;2019."},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aucc.2020.10.011"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000005145"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-019-05570-9"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-020-06234-9"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001432"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2016.11.47"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.13520"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-020-06306-w"},{"key":"e_1_2_13_21_1","first-page":"1","article-title":"Guidance for: prone positioning in adult critical care","author":"Bamford P","year":"2019","journal-title":"Intensive Care Soc"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/wvn.12177"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006199-198707000-00002"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc1995.4.5.361"},{"key":"e_1_2_13_25_1","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2022"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-021-03723-1"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2021.103088"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/nicc.12606"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s42399-021-01008-w"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2021.103033"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2019.06.002"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-022-02026-7"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202006-625OC"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.123.5.1589"},{"issue":"3","key":"e_1_2_13_35_1","first-page":"307","article-title":"Prone positioning during veno\u2010venous extracorporeal membrane oxygenation for severe acute respiratory distress syndrome in adults","volume":"80","author":"Guervilly C","year":"2014","journal-title":"Minerva Anestesiol"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/0267659113502834"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.4037\/ccn2020222"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-013-3188-1"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-020-03110-2"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000001646"},{"issue":"4","key":"e_1_2_13_41_1","first-page":"50","article-title":"Pressure ulcer development and vasopressor agents in adult critical care patients: a literature review","volume":"59","author":"Cox J","year":"2013","journal-title":"Ostomy Wound Manage"}],"container-title":["Nursing in Critical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nicc.12889","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nicc.12889","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nicc.12889","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T05:16:41Z","timestamp":1706591801000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nicc.12889"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,5]]},"references-count":40,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1111\/nicc.12889"],"URL":"https:\/\/doi.org\/10.1111\/nicc.12889","archive":["Portico"],"relation":{},"ISSN":["1362-1017","1478-5153"],"issn-type":[{"value":"1362-1017","type":"print"},{"value":"1478-5153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,5]]},"assertion":[{"value":"2022-11-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}