Risk factors and clinical relevance of nosocomial maxillary sinusitis in the critically ill.

Rouby, Jean‐Jacques; Laurent, Pierre-Alexandre; Gosnach, M; Cambau, Emmanuelle; Lamas, G.; Zouaoui, A.; Leguillou, Jean-Luc; Bodin, L.; Khac, T D; Marsault, C.

doi:10.1164/ajrccm.150.3.8087352

Cited by 282 publications

(175 citation statements)

References 20 publications

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“…Alternatively, the process may be infectious but not VAP. The clinician should consider empyema, lung abscess, Clostridium difficile colitis, urinary tract infection, and sinusitis (139,172) (Table 4). Candida species, while commonly cultured from patients, rarely cause invasive pulmonary disease, even when quantitative thresholds are exceeded (58,166,210).…”

Section: Antibiotic Managementmentioning

confidence: 99%

Ventilator-Associated Pneumonia: Diagnosis, Treatment, and Prevention

2006

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SUMMARY While critically ill patients experience a life-threatening illness, they commonly contract ventilator-associated pneumonia. This nosocomial infection increases morbidity and likely mortality as well as the cost of health care. This article reviews the literature with regard to diagnosis, treatment, and prevention. It provides conclusions that can be implemented in practice as well as an algorithm for the bedside clinician and also focuses on the controversies with regard to diagnostic tools and approaches, treatment plans, and prevention strategies.

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Section: Antibiotic Managementmentioning

confidence: 99%

Ventilator-Associated Pneumonia: Diagnosis, Treatment, and Prevention

2006

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“…The incidence of infectious maxillary sinusitis and its relationship to VAP were prospectively studied in critically ill patients who were mechanically ventilated for a period .7 days [10]. Infectious maxillary sinusitis was significantly associated with VAP and its frequency was markedly reduced by inserting endotracheal and gastric tubes via the oral route and not via the nares.…”

Section: Discussionmentioning

confidence: 99%

“…The presence of a nasogastric tube has been identified as an independent risk factor for VAP [7,8]. The potential advantage of performing an early gastrostomy over using a nasogastric tube is the possibility of avoiding dysfunction of the upper and lower oesophageal sphincters and development of maxillary sinusitis, both of which are associated with VAP [9,10].…”

mentioning

confidence: 99%

Early gastrostomy reduces the rate of ventilator-associated pneumonia in stroke or head injury patients

Kostadima

Kaditis²,

Alexopoulos³

et al. 2005

Eur Respir J

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Presence of a nasogastric tube is a risk factor for the development of ventilatorassociated pneumonia (VAP). Alternatively, gastrostomy can be used for administration of enteral feedings.To determine whether early performance of gastrostomy affects frequency of VAP, a randomised, controlled study was carried out in patients mechanically ventilated for stroke or head injury. In the gastrostomy group, patients underwent the procedure within 24 h of intubation. A nasogastric tube was inserted in controls. Individual subjects were studied for 3 weeks.In total, 20 subjects (mean age 48¡15.2 yrs) were allocated to the gastrostomy group, and 21 to the control group (46.6¡15.4 yrs). Of these groups, two (10%) and eight (38.1%) developed VAP, respectively. Four patients with gastrostomy and three controls did not complete the study (due to weaning from ventilatory support or death). After excluding these subjects, difference in VAP frequency persisted: two out of 16 subjects with gastrostomy had VAP (12.5%) versus eight out of 18 controls (44.4%). There were no differences in duration of hospitalisation or mortality between the two groups.In conclusion, in patients mechanically ventilated for stroke or head injury early gastrostomy is associated with a lower frequency of ventilator-associated pneumonia compared with a nasogastric tube.

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“…The risk of nosocomial sinusitis is increased with nasotracheal and nasogastric intubation [43]. The incidence (1.4-100%) of sinus infection is often underestimated because of a lack of clinical signs.…”

Section: Sinusesmentioning

confidence: 99%

“…The use of oral rather than nasal tracheal intubation has been associated with lower rates of VAP, and is due to the reduced incidence of sinusitis with oral as opposed to nasal tracheal and gastric tubes (95.5% vs. 22.5%) [43,44].…”

Section: Oral Vs Nasal Intubationmentioning

confidence: 99%

Ventilator‐associated pneumoniaDiagnosis, pathogenesis and prevention

Young¹,

Ridley²

1999

Anaesthesia

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SummaryVentilator-associated pneumonia is common, difficult to diagnose, affects the most vulnerable of patients and carries a high mortality. During prolonged mechanical ventilation the oropharynx, sinuses, dentition and stomach of critically ill patients become colonised with pathogenic bacteria. Colonised secretions pool in the oropharynx and subglottic space. These secretions repeatedly gain access to the lower airways by leakage past the tracheal tube cuff. If host defence mechanisms are overwhelmed, multiplication occurs in the lower respiratory tract producing an inflammatory response in the bronchioles and alveoli. The inflammatory response is characterised by capillary congestion, leucocyte and macrophage infiltration and fibrinous exudation into the alveolar spaces. If this inflammatory response occurs more than 48 h after intubation, it is called ventilatorassociated pneumonia. Prevention depends on reducing upper airway and gastrointestinal reservoirs of bacteria, reducing or abolishing aspiration of these bacteria past the tracheal tube cuff and enhancing bacterial clearance from the lower airways. Despite an increased understanding of the pathogenesis and diagnosis of ventilator-associated pneumonia (VAP), prevention has remained problematic. There is now good evidence for continuous leakage of infected secretions past the tracheal tube cuff being responsible for VAP. As a result, VAP strikes critically ill patients and increases their morbidity and mortality. The aim of this review is to discuss the diagnosis and pathogenesis of VAP, including a brief review of natural defence mechanisms. The review also covers the prevention of VAP with special reference to new developments aimed at reducing aspiration past the cuff. Definition

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Risk factors and clinical relevance of nosocomial maxillary sinusitis in the critically ill.

Cited by 282 publications

References 20 publications

Ventilator-Associated Pneumonia: Diagnosis, Treatment, and Prevention

Ventilator-Associated Pneumonia: Diagnosis, Treatment, and Prevention

Early gastrostomy reduces the rate of ventilator-associated pneumonia in stroke or head injury patients

Ventilator‐associated pneumoniaDiagnosis, pathogenesis and prevention

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