The occurrence and spreading of paranasal sinus changes among critically ill patients undergoing invasive ventilation : an observational cohort study
Jansson, Miia M.; Karhu, Jaana M.; Ahvenjärvi, Lauri; Autio, Timo J.; Syrjälä, Hannu P.; Ala-Kokko, Tero I. (2020-02-14)
Jansson MM, Karhu JM, Ahvenjärvi L, Autio TJ, Syrjälä HP, et al. (2020) The Occurrence and Spreading of Paranasal Sinus Changes among Critically Ill Patients Undergoing Invasive Ventilation: An Observational Cohort Study. Infect Dis Diag Treat 4: 137. DOI:10.29011/2577-1515.100137
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https://urn.fi/URN:NBN:fi-fe2020082864567
Tiivistelmä
Abstract
Background: The development of ventilator-associated pneumonia could be prevented in the nasotracheally intubated patients by a systematic search for and treatment of nosocomial sinusitis. However, the spreading of paranasal sinus changes with time is poorly defined.
Purpose: To evaluate the occurrence and spreading of paranasal sinus changes among critically ill patients undergoing invasive ventilation in order to evaluate the association between paranasal changes and Intensive Care Unit (ICU)-related outcomes.
Material and methods: This prospective, observational, single-center cohort study was conducted in a single tertiary-level teaching hospital in Finland during 2014–2015. All invasively ventilated adult patients referred for head computed tomography or magnetic resonance imaging scans from October 2014 to June 2015 were eligible for enrolment and monitored daily until discharge from the ICU or death.
Results: During the study period, 6.8% (5.7 per 1,000 patient days) of patients had major findings in their maxillary, 20.3% (18.5 per 1,000 patient days) in sphenoidal, 6.8% (5.7 per 1,000 patient days) in ethmoidal, and 3.4% (2.9 per 1,000 patient days) in frontal sinuses. The spreading of paranasal sinus changes doubled in time. In addition, radiographically proved accumulation of fluid was within 39.0%, 35.6%, and 8.6% of maxillary, sphenoidal, and frontal sinuses, respectively. We found no association between ICU-related outcomes and paranasal sinus changes.
Conclusion: Paranasal sinus changes were common and progressive among critically ill patients undergoing invasive ventilation, without unfavourable impact on ICU-related outcomes.
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