Mediastinite no Hospital de Base do Distrito Federal: incidência em seis anos

Schimin, Luiz Carlos; Batista, Raelson de Lima; Mendonça, Frederico Carlos Cordeiro de

doi:10.1590/s0102-76382002000200008

Cited by 8 publications

(12 citation statements)

References 12 publications

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“…Several studies [15][16][17] have pointed Staphylococcus aureus as the main germ responsible for the development of mediastinitis and with our casuistics it was not otherwise. It is curious to observe that all the positive cultures were monobacterial, considering that it is expected about 40% of mixed infections [1,5].…”

Section: Discussionsupporting

confidence: 56%

Mediastinite no pós-operatório de cirurgia cardiovascular: análise de 1038 cirurgias consecutivas

Sá¹,

Silva

Lima³

et al. 2010

Rev Bras Cir Cardiovasc

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Results: On average, complication occurred within 13 days after operation; in a total of 25 lethal cases (2.4%), deaths occurred in eight (32%). Several risk factors for mediastinitis were identified as follows: 56% diabetes, 56% smoking, 20% obesity, 16% chronic obstructive pulmonary disease, and 8% end-stage renal disease. Mediastinitis was reported in 21 (84%) patients submitted to coronary artery bypass grafting and it was related to a major risk for development of infection (IC 3.44-8.30, P=0.0001). High rates of complications were observed: respiratory failure (44%), stroke (16%), cardiogenic shock (12%), acute renal failure (28%), pulmonary infection (36%), multiple organs failure (16%), and sternal dehiscence (48%). Bacterial cultures of exudates were positive in 84% of patients; Staphylococcus aureus was the most frequently pathogen (28.8%) detected.Conclusion: Mediastinitis remains as a severe surgical complication and difficult to manage in postoperative cardiovascular surgery. The disease has low incidence rate but high lethality. Coronary bypass was associated to a major risk for development of infection.Descriptors: Infection. Mediastinitis. Cardiac surgical procedures.

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Section: Discussionsupporting

confidence: 56%

Mediastinite no pós-operatório de cirurgia cardiovascular: análise de 1038 cirurgias consecutivas

Sá¹,

Silva

Lima³

et al. 2010

Rev Bras Cir Cardiovasc

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“…(3,(5)(6) However, esophageal perforation should not be forgotten since it is responsible for the highest mortality rates. (7)(8)(9)(10)15) Among the infectious agents involved, S. aureus and S. epidermidis are the most frequently found. Similar results have been reported in the literature, and some studies have also shown that the isolation of E. coli is correlated with a high mortality rate.…”

Section: Discussionmentioning

confidence: 99%

“…(3) Inflammation of the mediastinum may have several causes, chief among which are median sternotomy (3,5) and esophageal perforation (Boerhaave's syndrome, dilatations, foreign bodies, etc. ), (7)(8)(9)(10) as well as head and neck suppurations such as peritonsillar abscesses, deep cervical abscesses, etc. (4,(11)(12) Other less common causes include pleural empyema, osteomyelitis of the vertebrae and ribs, retroperitoneal abscesses and subphrenic abscesses.…”

Section: Introductionmentioning

confidence: 99%

Mediastinite aguda: análise retrospectiva de 21 casos

2005

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Objective: To evaluate the epidemiological and clinical aspects of acute mediastinitis and to characterize its treatment. Methods: A retrospective study conducted through review of the medical charts of patients diagnosed with acute mediastinitis at the Hospital Escola da Faculdade de Medicina do Triângulo Mineiro (Triângulo Mineiro Medical School Hospital) between 1987 and 2004. Results: A total of 21 patients were studied. Most (76.2%) were male, and the mean age was 52.5 years. Six patients (28.6%) died. The most common cause (in 38.1%) was median sternotomy, followed by esophageal perforation (in 33.3%) and cervical infection (in 14.3%). Staphylococcus aureus and Staphylococcus epidermidis were the causative agents most frequently isolated. In most cases, the treatment of choice was antibiotic therapy accompanied by surgery. The most frequent complications of the acute mediastinitis were pleural effusions (in 23.8%) and osteomyelitis (in 19.0%). The average hospital stay was 26.6 days. Conclusion: Acute mediastinitis is a serious complication of some diseases and procedures. Despite its low incidence, the mortality rate is high. Staphylococcus aureus and Staphylococcus epidermidis are the most common causative agents. The treatment used was antibiotic therapy accompanied by surgery.

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“…Diagnosing the infectious process before patient discharge to establish an early and adequate therapy interferes decisively to infection control and decrease of death cases caused by mediastinitis [8].…”

Section: Introductionmentioning

confidence: 99%