Ventilator-associated sinusitis in adults: Systematic review and meta-analysis - 16/06/12
Corresponding author. Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 151 23 Marousi, Athens, Greece. Tel.: +30 694 611 0000; fax: +30 210 683 9605.Summary |
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.
Le texte complet de cet article est disponible en PDF.Keywords : Ventilator-associated pneumonia, Mortality, Bloodstream infections
Plan
Vol 106 - N° 8
P. 1082-1095 - août 2012 Retour au numéro
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