Application of an original improved U-pillow in patients with prone position ventilation: A comparative retrospective observational study

Patients in the prone position in the intensive care unit are at risk of facial skin failure, a concern that has traditionally been managed through frequent repositioning, often necessitating considerable effort from healthcare practitioners. This study aims to evaluate the effectiveness of an original improved U-shaped pillows in preventing pressure injuries to the head and face of patients undergoing prone ventilation. A retrospective analysis was conducted on data from 61 patients who underwent prone positioning ventilation. The study group consisted of 31 patients who used the improved U-shaped pillow, which features 7 independent air chambers designed for dynamic segmental pressure regulation. The control group was composed of 30 patients who underwent decompression using traditional integrated U-shaped sponge pillows, which lack pressure-adjustment capabilities. There were no significant differences between the 2 groups at baseline. While the intergroup difference in facial pressure injury incidence was not statistically significant (6.5% vs 23.3%, P = .081) and no significant benefit was detected in the univariate analysis ( P = .080), a significant advantage of the new pillow emerged after adjusting for potential confounders. In the multivariate regression analysis, the study group demonstrated a significantly reduced incidence of facial pressure injuries compared to the control group ( P = .048). A comparison of the average number of head position changes per hour between the 2 patient groups during prone positioning indicated that the study group demonstrated significantly better performance than the control group. This difference was statistically significant (0.55 ± 0.10 vs 0.68 ± 0.15, P <.001). The satisfaction level among nurses in the study group was significantly higher than that in the control group (3.61 ± 0.69 vs 3.04 ± 0.69, P = .003). A statistically significant positive correlation was identified between body mass index and pressure injury incidence ( P = .004). The application of the original improved U-shaped pillow was associated with a reduced incidence of craniofacial pressure injuries in prone-ventilated patients after adjustment for confounders, while also mitigating the clinical nursing burden and improving job satisfaction among healthcare staff.