The SIAP study examines the effect of using the Inflatable Prone Support (IPS) of Ergotrics on Intra-Abdominal Pressure (IAP) during spine surgery.
The aim of this study is to demonstrate that the Inflatable Prone Supports (IPS) are able to lower the IAP of patients in the prone position. When the patient’s position is changed to the prone position, the IAP is increased as a result of abdominal compression. It has previously been shown that increased IAP is linked to increased bleeding. The ability to reduce IAP is assessed by measuring IAP before and after inflation of the IPS.
Together with UZ Gent, Liantis investigated whether the use of compressed air and inflatable cushions can reduce the physical load for healthcare workers. The study compared three different proning methods: (1) compressed air and inflatables, (2) turning table and foam supports, (3) tilting and foam supports. Six test persons had to move a patient from the supine to the prone position using these three different tools. For each of the three methods, the muscle tension of the subject’s shoulder muscles and low back muscles was measured to see which method was the least physically demanding.
Proning with compressed air resulted in a significant lower muscle strain for the subjects compared to the other, manual methods. The inflatable cushions not only resulted in less shoulder strain, but this method was also significant less demanding on the back muscles.
In short: using compressed air can ensure that employees in the care sector are less likely to suffer from lower back pain.
To map the user feedback of the IBO, IPS and Hummingbird, Ergotrics, with the financial support of Flanders Innovation & Entrepreneurship, organised the OPPE study (Optimization of the Proning Procedure in Europe).
10 renowned hospitals in 5 countries participated in the study: Universitätsspital Zürich, Switzerland; Krankenhaus Wermelskirchen, Germany; Schön Klinink Vogtareuth, Germany; Universitair Ziekenhuis Brussel, Belgium; Akademiska sjukhuset Uppsala, Sweden; Elisabeth-Tweesteden Hospital, the Netherlands; MC Zuyderland Heerlen, the Netherlands; Erasmus MC, the Netherlands; Heilig Geist Hospital Bensheim, Germany; AZ Nikolaas, Belgium.
Pressure Point Study
Pressure points on the skin increase the risk of pressure ulcers. This study will compare the pressure over the entire surface of the breast and pelvic skin when positioned on the IPS and other positioning systems.
All patients undergoing (long-term) surgery are at risk of developing pressure ulcers. Research has shown that it is important to keep pressure below 30mmHg to prevent pressure ulcers. It is generally accepted that air results in a better redistribution of pressure. Therefore, it is likely that redistribution of the pressure will reduce the associated risk. This study shows the pressure redistribution and identifies the areas of highest pressure using pressure mapping. Different positioning materials (Ergotrics’ Inflatable Prone Support (IPS), Steffee cushion, Wilson-Frame, traditional gel / foam filled cushions / bolsters / rolls) will be compared in terms of pressure distribution and areas with the highest pressure.
According to the review published by Depauw et al. (2019), the incidence of complications arising from increased IAP, known as intra-abdominal hypertension (IAH) or abdominal compartment syndrome in critically ill patients, can be high and its impact can be significant.
How many nurses suffer from back pain? Why are the ergonomic challenges so big in healthcare? What is the cost of the ergonomic burden in healthcare?
Ergotrics summarizes more than 20 publications around ergonomics in healthcare in one comprehensive article. For a short version: watch the video made by EIT Health and Ergotrics.
Dirkes, Dickinson, Havey and O’Brien (2012) emphasize the benefits of prone ventilation and positioning. However, this procedure also entails potential risks and complications, which can have consequences for both the patient and the healthcare provider. For example, lifting patients to prone position can cause back and other injuries to staff.
Dirkes, S., Dickinson, S., Havey, R., & OʻBrien, D. (2012). Prone Positioning. Critical Care Nursing Quarterly, 35(1), 64–75. https://doi.org/10.1097/cnq.0b013e31823b20c6
Moving and lifting patients is an inherent part of everyday work for many health professionals in the EU, for example with older, obese or disabled patients. However, good technique with consistent use of assistive devices helps to partially reduce excessive risk.
Lars L. Andersen, MSc, PhD. Musculoskeletal disorders in the healthcare sector. Discussion paper.
“In 2018 Guérin et al published a prospective international prevalence study (APRONET study) showing that Prone Ventilation was used in 32.9 % of severe ARDS (Adult Respiratory Distress Syndrome) and was associated with low rate of complications, a significant increase in oxygenation, and a decrease in driving pressure.”
Guérin et al. A prospective international prevalence study on prone position of ARDS patients: the APRONET (ARDS Prone Position Network) study.Intensive Care Med. 2018;44:22-37
“The chest and the abdomen are inexorably linked and must be considered as a single unit. Kirkpatrick et al already suggested the benefits of thoracopelvic supports in the ICU in a clinical review on intraabdominal hypertension (IAH) and its influence on the physiology of Prone Ventilation (PV).”
Kirkpatrick AW, Pelosi P, De Waele JJ et al.: Clinical review: Intra-abdominal hypertension: does it influence the physiology of prone ventilation. Crit Care 2010; 14: 232. doi: 10.1186/cc9099.
Prof. Sheila Nainan Myatra (2021) published these expert consensus statements:
97.3% of experts agree that “Prone position during invasive mechanical ventilation of C-ARF improves oxygenation”, while none disagree.
Nasa et al. Crit Care (2021) 25:106