Abstract:
OBJECTIVE:To investigate the incidence, risk factors and mortality of ventilator-associated pneumonia (VAP) in intensive care unit (ICU) patients. DESIGN:Prospective, observational, population-based study. SETTING:The medical (14-bed) and surgical ICU (26-bed) of the Ghent University Hospital. METHODS:All 1295 patients admitted to the ICU during 4 three-month periods between 1996 and 1998 were included. A set of demographic and clinical variables were collected at the day of admission and during the ICU course. RESULTS:The incidence of VAP among ICU patients ventilated at least 48 hours was 23.1%. The mean time to the development of VAP was 9.6 days with a median of 6 days. In the population of patients ventilated for at least 48 hours, a comparison was made between patients with (n = 89) and without VAP (n = 296). Patients with VAP had a significant longer ICU stay, with a longer ventilation dependency. Logistic regression analysis identified admission diagnosis other than trauma (OR: 0.51, 95% CI: 0.29-0.89; p = 0.02) and the length of ICU stay (OR: 1.05, 95% CI: 1.03-1.07; p < 0.001) to be independently associated with the acquisiton of VAP. In comparison with the total study population, patients with VAP had a higher ICU mortality (20.2% vs. 12.0%; p = 0.04), but not in the cohort group of patients at risk for VAP (ventilated > 48 hours)(20.2% vs. 31.3%; p = 0.03). The factors independently associated with death were higher SAPS II scores (OR 1.02, 95% CI: 1.003-1.032; p = 0.02), an admission diagnosis other than trauma (OR 0.36, 95% CI: 0.17-0.75; p = 0.006) and length of ICU stay (OR 0.97, 95% CI: 0.946-0.995; p = 0.02). This model did not recognize VAP as an independent predictor of death (OR 0.79, 95% CI: 0.41-1.53; p = 0.492). CONCLUSIONS:The incidence of VAP in our ICU is 23.1%. Length of ICU stay and an admission diagnosis other than trauma are major risk factors for the development of this nosocomial infection. VAP is associated with a high fatality rate. However, after adjustment for disease severity and length of ICU stay, VAP was not identified as an independent predictor of death.
journal_name
Acta Clin Belgjournal_title
Acta clinica Belgicaauthors
Myny D,Depuydt P,Colardyn F,Blot Sdoi
10.1179/acb.2005.022keywords:
subject
Has Abstractpub_date
2005-05-01 00:00:00pages
114-21issue
3eissn
1784-3286issn
2295-3337journal_volume
60pub_type
杂志文章abstract::Azole antifungals are a group of fungistatic agents that can be administered orally or parenterally. The determination of the concentrations of these antifungals (miconazole, fluconazole, ketoconazole, posaconazole, voriconazole, itraconazole, and its major active metabolite, hydroxy-itraconazole) in serum can be usef...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/0001551213Z.00000000018
更新日期:2014-01-01 00:00:00
abstract::The differential diagnosis between hypertonic, isotonic and hypotonic hyponatremia are presented. The help of some usual serum (urea, uric acid and TCO2) and urine parameters (mainly osmolality and sodium concentration) are discussed and help to determine the best treatment. Morbidity associated with untreated hyponat...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2018.1531616
更新日期:2019-02-01 00:00:00
abstract::The present study compares two new factor VIII preparations currently used in the treatment of haemophilia. A Factor VIII was partially purified from plasma obtained from unpaid voluntary Belgian donors in the blood transfusion centers of Lille and Amsterdam and virus-inactivated by exposure to solvent-detergent (FVII...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.1991.11718180
更新日期:1991-01-01 00:00:00
abstract::A tired 32-year-old woman complaining of tiredness was referred for work-up of a possible immune deficiency. She had a history of recurrent infections since birth, which usually responded to antibiotics within a few days. Her mother, a nurse, had reported that early charts had disappeared. Munchausen's by proxy was su...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.2143/ACB.66.2.2062531
更新日期:2011-03-01 00:00:00
abstract::We report the case of a 32-year-old patient with Wegener's granulomatosis (WG) associated with a (biopsy - proven) renal inflammatory pseudotumour (IPT) of the left kidney treated by a partial nephrectomy, glucocorticoids and immunosuppressive drugs, in whom a relapse of renal IPT was found 6 years after the diagnosis...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/acb.2010.65.6.011
更新日期:2010-11-01 00:00:00
abstract::Introduction: Vitamin K plays an important role in blood coagulation. Diet is the main source of vitamin K and body stores are depleted in days, hence deficiency is common in malnourished older people. A high proportion of people who sustain a hip fracture are already malnourished, compounded by fasting for surgery wh...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2018.1564174
更新日期:2020-04-01 00:00:00
abstract::Coronary artery disease is frequently associated with disturbed blood lipids and with a deficient blood fibrinolytic capacity. In order to investigate a possible link between hypercholesterolemia and hypofibrinolysis, we have investigated the effect of simvastatin, a HMG-CoA reductase inhibitor, on blood lipids and fi...
journal_title:Acta clinica Belgica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1080/17843286.1992.11718214
更新日期:1992-01-01 00:00:00
abstract::Allogeneic hematopoietic stem cell transplantation (HSCT) is used for the treatment of selected hematological malignancies. Its curative potential is based on two very different mechanisms, involving the conditioning regimen and the graft-versus-host reactions, respectively. The high-dose chemo-radiotherapy conditioni...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1179/acb.2003.58.1.005
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Immunotherapy represents a recent milestone in the treatment of lung cancer, particularly with the rapidly expanding development of monoclonal antibodies targeting checkpoint inhibitors in the programmed cell death-1 (PD-1) pathway, such as nivolumab and pembrolizumab. Classical auto-immune side effects of t...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2019.1629078
更新日期:2020-08-01 00:00:00
abstract::The purpose of this study was to characterize the clinical picture of macroprolactinemic patients and to further assess whether macroprolactinemia was part of an auto-immune syndrome. Eighty-two hyperprolactinemic (serum PRL > 1000 mU/l) patients were investigated and the PEG precipitation test identified 14 patients ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/acb.2005.034
更新日期:2005-09-01 00:00:00
abstract::Although post-transplant lymphoproliferative disorder is a classical complication encountered after kidney transplantation, its diagnosis can still be challenging and its outcome life-threatening. Most cases are related to Epstein-Barr virus (EBV) infection and occur mainly in the first year post-transplant, favoured ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/2295333714Y.0000000112
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Automated insulin calculators (AICs) with carbohydrate counting (CHC) have been shown to be effective in improving glycated haemoglobin (HbA1c) levels. By contrast, use of AICs without CHC, with predetermined prandial insulin doses modified according to a correction factor and modulated as a function of glyc...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2015.1116151
更新日期:2016-02-01 00:00:00
abstract::The diffuse infiltration by plasma cells in the liver is not uncommon in multiple myeloma (MM). However, a MM with hepatic mass is very unusual. We report a case of a 75-year-old male with hepatomegaly and a lesion occupying a voluminous space in the liver. A lambda light chain multiple myeloma was found in the check-...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.2143/ACB.67.5.2062696
更新日期:2012-09-01 00:00:00
abstract::A patient with invasive pulmonary aspergillosis due to an azole-resistant Aspergillus fumigatus is described. Despite treatment change from voriconazole to amphotericin B as soon as the resistance data were available, the patient died. Azole resistance is an emerging problem, which significantly complicates the manage...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.2143/ACB.67.1.2062627
更新日期:2012-01-01 00:00:00
abstract::We performed a systematic survey of original papers published in The Lancet throughout the years 1945, 1946, 1970 and 1995. The Lancet was chosen due to a conservative layout through these years, and the year 1946 added to the analysis to ponder for any war-induced bias. The general layout and structure of the journal...
journal_title:Acta clinica Belgica
pub_type: 历史文章,杂志文章
doi:10.1179/acb.2004.011
更新日期:2004-03-01 00:00:00
abstract::Malakoplakia is a rare inflammatory disease involving most frequently the urinary tract. We present a case of bilateral renal malakoplakia, in which FDG-PET contributed to diagnosis. We made this diagnosis on the basis of clinical presentation, renal biopsy showing a mixed cellular infiltrate with granuloma formation ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/acb.2004.020
更新日期:2004-05-01 00:00:00
abstract::The availability of antiretroviral therapy (ART) has significantly improved the quality of life of persons with HIV infection. However, new problems have arisen as a consequence of this treatment. An immune reconstitution inflammatory syndrome (IRIS) in which patients experience a paradoxical worsening of their clinic...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.2143/ACB.3281
更新日期:2013-07-01 00:00:00
abstract:INTRODUCTION:Intra-abdominal hypertension (IAH) and subsequent abdominal compartment syndrome (ACS) in burned patients is common. This sequence of events typically occurs in patients with larger burns receiving high volume fluid resuscitation. METHODS:A review of the literature was performed. The National Library of M...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/acb.2007.62.s1.017
更新日期:2007-01-01 00:00:00
abstract::Over the past few years there have been enormous changes in the management of stroke patients. General practitioners, ambulance personnel/paramedics and the general public need to be well informed that stroke is a medical emergency. Prevention of secondary brain damage by normalising vital parameters and combating fev...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1080/17843286.1999.11754250
更新日期:1999-10-01 00:00:00
abstract::Non-closure of abdominal fascia and the resultant open abdomen after laparotomy has become a major advance in the management of critically ill or injured patients. The benefits of open abdomen are many and include the prevention of intra-abdominal hypertension and the consequent abdominal compartment syndrome. Appropr...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/acb.2007.62.s1.027
更新日期:2007-01-01 00:00:00
abstract::A 69-year-old man with slight dyspnoea underwent routine X-ray examination by his primary care physician. The X-ray and the CT showed a homogenous mass at the right side of the anterior mediastinum. The benignity and the origin of the tissue were still unknown. Therefore, we performed a CT-guided fine needle aspiratio...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.2143/ACB.67.4.2062679
更新日期:2012-07-01 00:00:00
abstract::Foodborne disease represents a major problem for public health in industrialized countries, albeit with a low lethality. Foodborne diseases are defined as a group of viral, bacterial or parasitic gastrointestinal infections transmitted by means of food. Proper food-hygiene practices and surveillance of individual dise...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2000.11754316
更新日期:2000-11-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Sarcoidosis is a multisystem inflammatory disorder of unknown etiology. It is characterized by the presence of noncaseating granulomas and an inflammatory process in which T lymphocytes, especially type-1 helper T (Th1) cells, macrophages and different cytokines are involved. Different studies ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2016.1152671
更新日期:2016-12-01 00:00:00
abstract::25 hospitalized patients, suffering from acute bronchopulmonary affections, received every 24 hours, one I.M. injection of 750 mg of tetracycline laurylsulfate (equivalent to 500 mg of tetracycline HCl). Positive clinical results were obtained in all cases. All isolated micro-organisms, sensitive in vitro to tetracycl...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.1972.11716815
更新日期:1972-01-01 00:00:00
abstract::Significant visceral edema associated with massive fluid resuscitation, paralytic ileus and formation of pancreatic ascites in patients with severe acute pancreatitis (SAP) can lead to abdominal compartment syndrome (ACS) that can contribute to the early development of multiple organ dysfunction syndrome (MODS), espec...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:
更新日期:2007-01-01 00:00:00
abstract:INTRODUCTION:In many health care systems, strategies are currently deployed to engage patients and other stakeholders in decisions affecting hospital services. In this paper, a model for stakeholder involvement is presented and evaluated in three Flemish hospitals. In the model, a stakeholder committee advises the hosp...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2016.1246681
更新日期:2017-02-01 00:00:00
abstract::Cancer-related fatigue (CRF) is the most commonly reported symptom in patients with cancer with a prevalence up to 100%. It has a significant negative impact on quality of life. An effective management of CRF could significantly reduce the disease burden associated with cancer and its treatment. Unfortunately, the und...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1179/acb.2010.65.6.002
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVES:Some infections require prolonged parenteral antimicrobial therapy, which can be continued in an outpatient setting. The Ghent University Hospital has 15 years of experience with Outpatient Parenteral Antimicrobial Therapy (OPAT) in the home setting of the patient. METHODS:Multidisciplinary critical approac...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2016.1183285
更新日期:2016-10-01 00:00:00
abstract::We present the case of a 51-year-old woman who presented a right supraclavicular mass corresponding to lymphadenitis with atypical mycobacterium (Mycobacterium genavense). Later, she developed subcutaneous purulent small nodules containing the same germ. The presence of this mycobacterium was in the context of recurre...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/0001551213Z.00000000016
更新日期:2014-04-01 00:00:00
abstract::There is a need for legal control of sensitivity discs. False results are obtained by the use of discs containing an antibiotic and an unlabelled antimicrobial drug. Results of sensitivity tests (performed by the disc agar diffusion method) using Levocyclin8 discs furnished by the manufacturers were highly improbable....
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.1976.11717057
更新日期:1976-01-01 00:00:00