Prevention of nosocomial maxillary sinusitis in the ICU: the effects of topically applied alpha-adrenergic agonists and corticosteroids

Intensive Care Medicine
Ioannis PneumatikosDemosthenes Bouros

Abstract

We investigated the efficacy of locally applied nasal decongestant agents and corticosteroids for preventing nosocomial maxillary sinusitis in mechanically ventilated patients with multiple trauma. A prospective, open-label randomized study in two intensive care units (ICUs). 79 consecutive multiple trauma patients admitted to the ICU who were expected to be mechanically ventilated for more than 3 days. 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). 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. 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 asp...Continue Reading

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Citations

Jul 13, 2006·Intensive Care Medicine·Arthur R H van ZantenKees H Polderman
Apr 24, 2012·Respiratory Medicine·Michalis AgrafiotisMatthew E Falagas
Apr 27, 2016·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·J C Hurley
Oct 25, 2016·The Laryngoscope·Phillip HuyettEric W Wang
Mar 23, 2018·Annals of the American Thoracic Society·Jisha JoshuaLaura E Crotty Alexander
Jan 20, 2011·American Journal of Rhinology & Allergy·Fernando Mirage Jardim VieiraLuiz Carlos Gregório
Jan 3, 2018·American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses·Norma A MethenyKahee A Mohammed

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