Back to Search
Start Over
Prevention of nosocomial maxillary sinusitis in the ICU: the effects of topically applied alpha-adrenergic agonists and corticosteroids.
- Source :
-
Intensive Care Medicine . Apr2006, Vol. 32 Issue 4, p532-537. 6p. 1 Diagram, 3 Charts. - Publication Year :
- 2006
-
Abstract
- <bold>Objective: </bold>We investigated the efficacy of locally applied nasal decongestant agents and corticosteroids for preventing nosocomial maxillary sinusitis in mechanically ventilated patients with multiple trauma.<bold>Design and Setting: </bold>A prospective, open-label randomized study in two intensive care units (ICUs).<bold>Patients: </bold>79 consecutive multiple trauma patients admitted to the ICU who were expected to be mechanically ventilated for more than 3 days.<bold>Interventions: </bold>Patients were randomly assigned to receive either a combination of a locally applied nasal decongestant agents: 2 drops twice/day of xylometazoline nasal solution 0.1% and 100microg budesonide (NDCA group, n=39) or placebo (control group, n=40).<bold>Measurements: </bold>For the diagnosis of radiological maxillary sinusitis patients underwent paranasal computed tomography within 48h of admission and thereafter every 4-7 days. Infectious maxillary sinusitis was diagnosed by microbiological analysis of fluid aspirated after transnasal puncture of maxillary sinuses.<bold>Results: </bold>Radiological maxillary sinusitis was detected in 54% of patients in the NDCA group (n=21) but in 82% of controls (p<0.01), and infectious maxillary sinusitis in 8% of the NDCA group (n=3) but in 20% of controls (n=8; p=0.11). The most common pathogen micro-organisms identified from maxillary aspirates were Acinetobacter (32%) followed by anaerobes (21%).<bold>Conclusion: </bold>Our results indicate that the combination of locally applied xylometazoline hydrochloride and budesonide reduces the incidence of radiological maxillary sinusitis and may reduce also that of nosocomial maxillary sinusitis in mechanically ventilated patients with multiple trauma. [ABSTRACT FROM AUTHOR]
- Subjects :
- *NOSOCOMIAL infections
*SINUSITIS
*INTENSIVE care units
*PARANASAL sinuses
*INTRANASAL medication
*PHENYLPROPANOLAMINE
*CORTICOSTEROIDS
*ACINETOBACTER
*HORMONE therapy
*CROSS infection prevention
*ANAEROBIC bacteria
*COMPARATIVE studies
*CROSS infection
*GRAM-negative bacteria
*GRAM-positive bacteria
*LONGITUDINAL method
*RESEARCH methodology
*MEDICAL cooperation
*RESEARCH
*CUTANEOUS therapeutics
*EVALUATION research
*RANDOMIZED controlled trials
*PREVENTION
*THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 03424642
- Volume :
- 32
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- Intensive Care Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 20211580
- Full Text :
- https://doi.org/10.1007/s00134-006-0078-9