Document Detail


Ventilator-associated sinusitis in adults: Systematic review and meta-analysis.
MedLine Citation:
PMID:  22521223     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To review the epidemiology, risk factors for, treatment and outcome of ventilator-associated sinusitis (VAS). METHODS: We performed a systematic review and meta-analysis of available data without time restrictions. A conservative random effects model was employed to calculate pooled odds ratios (OR) and 95% confidence intervals (CIs). RESULTS: Out of 620 retrieved reports, 31 papers fulfilled our inclusion criteria. Infectious sinusitis affects 27% of mechanically ventilated patients and was found to be the cause of undetermined fever in 25% of the cases. Although radiographic VAS was higher in nasotracheally compared to orotracheally intubated patients (OR 4.66, 95% CI 1.35-16.13), clinical VAS was not (3.67, 0.80-6.81). The presence of VAS has been associated with the presence of VAP (3.66, 1.81-7.37) or bacteremia (6.85, 2.14, 21.92); however, it is unknown whether an etiologic relationship between them exists. In patients with concomitant VAS and VAP or bloodstream infections identical pathogens are isolated in 59% and 20% of the cases, respectively. The presence as opposed to absence of VAS was not associated with excess mortality (1.02, 0.35-3.01). CONCLUSION: VAS is a common infection in critically ill adults and correlates with other important infectious complications.
Authors:
Michalis Agrafiotis; Konstantinos Z Vardakas; Ioannis D Gkegkes; Anastasios Kapaskelis; Matthew E Falagas
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-19
Journal Detail:
Title:  Respiratory medicine     Volume:  -     ISSN:  1532-3064     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908438     Medline TA:  Respir Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ltd. All rights reserved.
Affiliation:
Alfa Institute of Biomedical Sciences (AIBS), Athens, Greece.
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