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Sinus infection in intensive care patients
E Mevio1, M Benazzo, S Quaglieri
1Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico San Matteo, Italy.
Rhinology
|December 1, 1996
Summary
Bacterial sinusitis affects 2% of intensive care unit patients with nasotracheal tubes. Early diagnosis and removal of nasal tubes are crucial for managing this complication.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Otolaryngology
Background:
- Nasotracheal intubation is associated with sinusitis, but its incidence remains unclear.
- Bacterial sinusitis is a potential complication in intensive care unit (ICU) patients requiring nasotracheal intubation.
Purpose of the Study:
- To determine the frequency of bacterial sinusitis in ICU patients with nasotracheal intubation.
- To identify predisposing factors, diagnostic methods, and effective management strategies for sinusitis in this patient population.
Main Methods:
- A two-year prospective study of 1,126 ICU patients.
- Diagnosis based on clinical sepsis, maxillary sinus fluid on imaging, and antral puncture.
- Microbiological analysis of sinus aspirates.
Main Results:
- Twenty-seven patients (2%) developed bacterial sinusitis.
- Common pathogens included Pseudomonas aeruginosa, Staphylococcus aureus, and Escherichia coli.
- Nasogastric and/or nasotracheal tubes were identified as likely predisposing factors.
Conclusions:
- Bacterial sinusitis is an uncommon but significant complication of nasotracheal intubation in the ICU.
- Prompt removal of nasal instrumentation, early sinus drainage, and broad-spectrum antibiotics are essential for effective management.