{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T15:24:52Z","timestamp":1766503492936,"version":"3.40.5"},"reference-count":15,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T00:00:00Z","timestamp":1698710400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014365","name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014365","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There is scarcity of data on the incidence and factors associated with the occurrence of ocular lesions in critically ill children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>Test the applicability and utility of an ocular assessment scale and to identify risk factors of ocular lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective observational study. A tertiary care medical\u2010surgical Paediatric Intensive Care Unit. 194 children without previous ocular disease who stayed in the Paediatric Intensive Care Unit for more than 48\u2009h. An ocular lesions risk scale was designed including risk factors lagophthalmos, eye dryness, conjunctival hyperemia, slow blinking, intubation, sedation, relaxation, face mask and hemodynamic instability. Patients were classified as high\u2010, medium\u2010, and low\u2010risk patients. Corneal lesions were examined by fluorescein staining according to their risk and were confirmed by an ophthalmologist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>76 patients were examined with fluorescein staining. Thirty\u2010two ocular lesions were detected by nursing staff, 26 confirmed by the ophthalmologist. 53.6% of the high\u2010risk patients developed a corneal lesion. Univariate analysis revealed an association between ocular damage and all factors included in the scale, except for face mask. In the multivariate analysis, ocular lesions were associated with lagophthalmos, hyperemia, invasive mechanical ventilation and inotropic support.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The scale was useful to detect corneal lesions in critically ill children. The identification of risk factors will enable the development of measures to reduce the incidence of ocular lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Relevance for Clinical Practice<\/jats:title><jats:p>A new, non\u2010validated scale allowed staff to detect eye injuries, study this problem and improve future prevention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nicc.12984","type":"journal-article","created":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T07:39:32Z","timestamp":1698737972000},"page":"1663-1671","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Early detection of ocular lesions in critically ill children: Testing an ocular assessment scale"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0400-3391","authenticated-orcid":false,"given":"Beatriz","family":"Vilchez","sequence":"first","affiliation":[{"name":"Pediatric intensive Care Department Gregorio Mara\u00f1\u00f3n General University Hospital  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Manzanal","sequence":"additional","affiliation":[{"name":"Pediatric intensive Care Department Gregorio Mara\u00f1\u00f3n General University Hospital  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Marcos","sequence":"additional","affiliation":[{"name":"Pediatric intensive Care Department Gregorio Mara\u00f1\u00f3n General University Hospital  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ver\u00f3nica","family":"Camacho","sequence":"additional","affiliation":[{"name":"Pediatric intensive Care Department Gregorio Mara\u00f1\u00f3n General University Hospital  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel Mar\u00eda","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Pediatric intensive Care Department Gregorio Mara\u00f1\u00f3n General University Hospital  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raquel","family":"La\u00edn","sequence":"additional","affiliation":[{"name":"Pediatric intensive Care Department Gregorio Mara\u00f1\u00f3n General University Hospital  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria del Mar","family":"San\u2010Segundo","sequence":"additional","affiliation":[{"name":"Pediatric intensive Care Department Gregorio Mara\u00f1\u00f3n General University Hospital  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gema","family":"Manrique","sequence":"additional","affiliation":[{"name":"Pediatric intensive Care Department Gregorio Mara\u00f1\u00f3n General University Hospital  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Pediatric intensive Care Department Gregorio Mara\u00f1\u00f3n General University Hospital  Madrid Spain"},{"name":"Health School Complutense University of Madrid  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jes\u00fas","family":"L\u00f3pez\u2010Herce","sequence":"additional","affiliation":[{"name":"Pediatric intensive Care Department Gregorio Mara\u00f1\u00f3n General University Hospital  Madrid Spain"},{"name":"Health School Complutense University of Madrid  Madrid Spain"},{"name":"Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Development Origin Network (RICORS) RD21\/0012\/0011 Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,10,31]]},"reference":[{"volume-title":"Eye Care for Critically ill Adults","year":"2021","author":"Johnson K","key":"e_1_2_11_2_1"},{"key":"e_1_2_11_3_1","first-page":"17","article-title":"Protecci\u00f3n ocular en los enfermos internados en la Unidad de Terapia Intensiva: Una propuesta de mejora de calidad y seguridad","volume":"30","author":"Carrillo Esper R","year":"2016","journal-title":"Rev Asoc Mex Med Crit Ter 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cuestionario","volume":"18","author":"Vilchez B","year":"2021","journal-title":"Evidentia"},{"doi-asserted-by":"publisher","key":"e_1_2_11_14_1","DOI":"10.3389\/fped.2021.795487"},{"key":"e_1_2_11_15_1","first-page":"587","article-title":"The Madrid triple classification of dry eye","volume":"78","author":"Murube J","year":"2003","journal-title":"Arch Soc Esp Oftalmol"},{"key":"e_1_2_11_16_1","first-page":"275","article-title":"Eye blink in newborn and preschool\u2010age children","volume":"86","author":"Lavezzo MM","year":"2008","journal-title":"Acta Ophthalmol"}],"container-title":["Nursing in Critical 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