Abstract
Descending necrotizing mediastinitis (DNM) is a highly morbid infectious process. This uncommon disease process has carried historically a substantial burden of morbidity and mortality. In this study we hypothesized that application of a prospective modified management algorithm would decrease the morbidity and mortality from this highly destructive process. We developed a systematic approach for managing DNM, focusing on serial debridement guided by imaging, in conjunction with the use of broad-spectrum antibiotics and modern principles of critical care. We reviewed all patients admitted with this disease process from 2007-2012. Data collected included demographic information, co-morbidities, laboratory data including culture results, operative details, imaging frequency and findings, complications, and survival. Continuous variables were reported as median values and ranges. From 2007-2010, we treated eight patients with DNM. The median age of the patients was 33 y (range 28-63 y), and 63% were male. In accordance with our algorithm, the patients underwent serial imaging at regular intervals following operative debridement. The median number of imaging studies was 11 (range 4-19). The patients required a median of five operat...Continue Reading
References
May 1, 1990·The Annals of Thoracic Surgery·M J WheatleyM B Orringer
Oct 1, 1985·The British Journal of Oral & Maxillofacial Surgery·G A Bounds
Mar 1, 1993·Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery·C Colmenero RuizJ Paniagua
Feb 1, 1996·The Journal of Thoracic and Cardiovascular Surgery·A BrunelliA Fianchini
Aug 1, 1997·Thorax·M J CorstenF Matzinger
Mar 17, 1999·The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyōbu Geka Gakkai Zasshi·S EndoH Nishino
Jan 29, 2000·The Journal of Thoracic and Cardiovascular Surgery·R K FreemanD E Wood
Jul 15, 2004·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Claresa S Levetan
Oct 1, 1938·Annals of Surgery·H E Pearse
Jun 27, 2008·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Jeong Su ChoYeon Joo Jeong
Jul 8, 2008·The Journal of Thoracic and Cardiovascular Surgery·Ke-Cheng ChenYung-Chie Lee
Oct 28, 2009·Annals of Surgery·Gerd J RidderJens Pfeiffer
Mar 4, 2011·Current Infectious Disease Reports·Annett Sandner, Jochen Börgermann
Nov 26, 2011·The Annals of Thoracic Surgery·Franck PetitpasAlexandre Mebazaa
Mar 28, 2012·The Annals of Thoracic Surgery·Cherie Parungo ErkmenJoseph A Paydarfar
Jul 5, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Gregor J KocherRalph A Schmid
Citations
Feb 2, 2016·Head & Neck·Héctor M Prado-CallerosIrma Jiménez-Escobar
Jan 14, 2016·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·B M BuchholzM Kaminski
Aug 12, 2016·Respirology Case Reports·Yusuke TakanashiKazuhito Funai
Nov 26, 2016·AORN Journal·Robert Montgomery, Sharon A McNamara
Jan 13, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Yasir Abu-OmarGiuseppe Cardillo