Sepsis from sinusitis in nasotracheally intubated patients

O’Reilly, Michael; Reddick, Eddie Joe; Black, W. L.; Carter, Preston L.; Erhardt, James; Fill, William L.; Maughn, Delray; Sado, Anthony; Klatt, Gordon R.

doi:10.1016/0002-9610(84)90122-3

Cited by 98 publications

(27 citation statements)

References 11 publications

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“…This demonstrates that the mechanical obstruction of the si¬ nus ostia by the nasal tube and the conditions in ICU patients lead to the dynamic process with edema, di¬ minished mucociliary cleansing of the sinus cavity, pro¬ liferating sinus flora, and inflammation. [2][3] Conditions in critically ill patients are important factors for the development of nosocomial sinusitis, but the nasotracheal tube can be seen as an additional risk.…”

Section: Resultsmentioning

confidence: 99%

Paranasal Sinusitis Associated With Nasotracheal and Orotracheal Long-term Intubation

Michelson

Schuster²,

Kamp³

1992

Archives of Otolaryngology - Head and Neck Surgery

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Section: Resultsmentioning

confidence: 99%

Paranasal Sinusitis Associated With Nasotracheal and Orotracheal Long-term Intubation

Michelson

Schuster²,

Kamp³

1992

Archives of Otolaryngology - Head and Neck Surgery

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“…If these patients with fever have occult sinusitis, then we are undertreating them. Undertreatment or failure to recognize sinusitis may evolve into other complications such as bacteremia, sepsis, or VAP (8, 11–15, 17). …”

Section: Discussionmentioning

confidence: 99%

“…In adult patients, those with nasotracheal tubes have a higher incidence of this complication than those with oral tubes (6–10). Furthermore, sinusitis in intubated adult patients can be an occult cause of fever and evolve into secondary complications such as bacteremia, sepsis, or ventilator associated pneumonia (VAP) (11–15). As a consequence, the 2004 joint guidelines by the American Thoracic Society and the Infectious Disease Society of America for VAP explicitly recommend that nasotracheal tubes be avoided.…”

Section: Introductionmentioning

confidence: 99%

Incidental sinusitis in a pediatric intensive care unit*

Moore

Blumberg

Laguna

et al. 2012

Pediatric Critical Care Medicine

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Objective Intubation is a risk factor for nosocomial sinusitis in adult intensive care patients. Sinusitis in intubated adults can be an occult cause of fever. In children nasal intubation may be associated with a greater risk of sinusitis. No pediatric study has determined the incidence of nosocomial sinusitis in the pediatric intensive care unit (PICU) setting. We hypothesized that within a subset of patients who had head CT imaging: (1) the incidence of sinusitis in PICU patients exceeds the incidence in non-PICU patients; (2) the incidence of sinusitis is greater in PICU patients with a tube (nasotracheal, nasogastric, orotracheal, or orogastric); and (3) nasal tubes confer an increased risk for sinusitis compared to oral tubes. Design Retrospective chart review Setting Independent not-for-profit pediatric healthcare system Patients PICU and non-PICU (inpatients hospitalized on medical-surgical wards) patients referred for head CT Interventions None Measurements and Main Results CT images were evaluated for the presence of a tube and sinusitis. Images were scored using the Lund-MacKay (LM) staging system. Sinusitis was defined as a LM score >3.5. 596 patients were studied; 395 (66.3%) PICU. 197 (50%) PICU versus 69 (34.3%) non-PICU patients had sinusitis (p <0.001). 108/147 (73.5%) PICU patients with a tube present had sinusitis versus 88/248 (35.9%) of those without a tube present (p <0.001). There was no significant difference in sinusitis based on tube location (p=0.218). Younger age or the presence of a tube increased the probability of sinusitis (p <0.001). Conclusions Almost 50% of our PICU patients imaged for reasons other than evaluation for sinus disease had evidence of sinusitis. This finding raises the concern that sinusitis in PICU patients is common and likely should be considered in the differential diagnosis of fever in PICU patients.

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“…The technique was further popularised in the 1920s by Magill [2], who preferred this technique for intra-oral surgery. At one time it was popular as a technique for prolonged intubation of patients in the intensive care setting [3], but risk of sinusitis [4] has reduced this use. Similarly, its popularity as an alternative to other techniques during routine anaesthesia has declined.…”

mentioning

confidence: 99%

Nasotracheal intubation for head and neck surgery

2003

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SummaryNasotracheal intubation offers the head and neck surgeon more scope for surgical manoeuvre in operations of the mouth, pharynx, larynx and also the neck. Concern over the complications of using this route of intubation and lack of training may be limiting its use. A thorough knowledge of the anatomy, benefits of using nasal vasoconstrictors and attention to technique are prerequisites to maintaining the skill. This article reviews each of these topics and aims to encourage the appropriate use of nasotracheal intubation in current practice.

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Sepsis from sinusitis in nasotracheally intubated patients

Cited by 98 publications

References 11 publications

Paranasal Sinusitis Associated With Nasotracheal and Orotracheal Long-term Intubation

Paranasal Sinusitis Associated With Nasotracheal and Orotracheal Long-term Intubation

Incidental sinusitis in a pediatric intensive care unit*

Nasotracheal intubation for head and neck surgery

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