Ventilator-associated sinusitis in adults: Systematic review and meta-analysis

Abstract

VAS is a common infection in critically ill adults and correlates with other important infectious complications.

Sinus opacification in the intensive care unit patient

“…Of particular concern is the hypothesis that ICU sinusitis serves as a bacterial reservoir driving the more prevalent and fatal healthcare‐associated pneumonia and bacteremia . One study of 399 nasotracheally intubated patients found that systematic evaluation for and treatment of ICU sinusitis reduced mortality and the frequency of hospital‐acquired pneumonia .…”

“…Given that a significant proportion of radiographic findings of sinusitis fail to correlate with positive cultures, the significance of such findings have been questioned . The supposition that ICU sinusitis serves as a reservoir for seeding nosocomial pneumonia and bacteremia, however, makes a greater understanding of ICU sinusitis important …”

“…Secondly, all but one study lack comparison imaging at the time of or prior to admission. The high prevalence of sinus inflammation in the general population and the absence of pre‐ICU imaging may therefore introduce bias when drawing conclusions concerning the incidence of ICU‐derived sinusitis . Finally, many studies are also limited to incomplete imaging of the paranasal sinuses (partial CT, ultrasound, or sinus X‐rays) by study design (e.g., maxillary aspirates) or confounded by the presence of facial fractures.…”

Prävention der nosokomialen beatmungsassoziierten Pneumonie

“…Der nasotracheale Zugangsweg führt zu einer höheren Inzidenz von Sinusitiden [116,117]; ein kausaler Zusammenhang zwischen Sinusitis und VAP ist nicht eindeutig belegt [118]. Ein Pro blem des nasotrachealen Zugangsweges ist die Gefahr der Schleimhaut-und Nasenseptumnekrosen.…”

Chronische Rhinosinusitis - ein häufiges Puzzleteil in der Pneumologie

“…Eine VAS (ventilator-associated sinusitis) ist eine häufige Komplikation bei invasiv und endonasal über einen endotrachealen Tubus beatmeten schwer kranken Patienten [19]. Ein Zusammenhang mit der Entstehung nosokomial-erworbener Pneumonien wird diskutiert [20,21].…”