Paranasal sinusitis and sepsis in ICU patients with nasotracheal intubation

✍ Scribed by H. Aebert; G. Hünefeld; G. Regel

• Book ID: 104685701
• Publisher: Springer
• Year: 1988
• Tongue: English
• Weight: 303 KB
• Volume: 15
• Category: Article
• ISSN: 1432-1238
• DOI: 10.1007/bf00255632

✦ Synopsis

During a 1-year period 4 out of 171 nasotracheally intubated patients (2.3%) developed sepsis due to purulent sinusitis. 98 (57%) of the patients received mechanical ventilation for more than 10 days. In all cases of sinusitis the diagnosis could be confirmed by conventional X-ray examination. Sepsis resolved 1 to 3 days after initiation of a therapy protocol consisting of tracheostomy, surgical drainage and lavage. Pseudomonas aeruginosa was involved as pathogenic organism in 3 of 4 patients. We conclude that purulent sinusitis represents a serious and often occult problem in already critically ill patients with multiple potential sources of sepsis. Most important for diagnosis is a high level of suspicion particularly in patients with risk factors for infection. Prompt and successful treatment can be achieved by an aggressive surgical approach.