Abstract:
BACKGROUND:Few studies have investigated the incidence of pulmonary anaerobes in a specific population in surgical Intensive Care Unit (ICU). The objective of this work was to determine the incidence of anaerobes in surgical ICU patients with suspected pneumonia. METHODS:This was a prospective observational, single-center study. Analysis was based on data collected over 30 months from the surgical ICU of a tertiary care hospital (Rouen University Hospital), including data on risk factors for anaerobes in the lungs. Patients with suspected pneumonia (community-acquired or nosocomial) were included. Bacteriological sampling was performed by protected distal bronchial sampling (PDBS) with minilavage under bronchoscopy. Aerobic and anaerobic cultures were performed for each sample. Clinicians were only aware of aerobic results. Univariate and multivariate statistical analysis compared groups with and without anaerobes. RESULTS:A total of 134 samples were obtained from 117 patients. Surgery was performed on 74 patients (63.2%), within 24 hours of admission. Fifty-four patients (46.2%) had a chest trauma and 20 patients (17.1%) were admitted for a digestive pathology. Average age was 53.6±20.9 years and sex ratio was 5.9 (100 men/17 women). Average SAPS II was 41.6±15.1, median length of ICU stay was 23 days (25th percentile=13, 75th percentile=33), and median duration of mechanical ventilation was 21 days (25th percentile=11, 75th percentile=28). Mortality rate in ICU was 14.5%. After sampling, diagnosis of pneumonia was confirmed in 70 cases (52.2%). Anaerobe cultures were positive in 11 samples taken from 11 different patients (overall incidence 8.2%). Aerobic bacteria were also involved in 9 patients (81.8%). In univariate analysis, enteral feeding (P=0.02) and absence of catecholamines at time of sampling (P=0.003) were significantly associated with the presence of anaerobes in PDBS. Enteral nutrition was also found to be a risk factor in multivariate analysis (OR=11.8, 95% CI [1.36 to 102.4] P=0.025). Prior antianaerobic antibiotic treatment was not a protective factor. No difference was observed regarding the notion of aspiration, survival, total length of stay and duration of mechanical ventilation, or evolution of pneumonia between the two groups. CONCLUSION:Our study demonstrates the presence of anaerobic bacteria in the lung samples of patients from surgical ICU with an incidence comparable to that found in populations from medical ICU departments. Anaerobic morbidity in our study is in line with recent literature.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Clavier T,Gouin P,Frebourg N,Rey N,Royon V,Bergis A,Hobeika S,Dureuil B,Veber Bsubject
Has Abstractpub_date
2014-10-01 00:00:00pages
1076-83issue
10eissn
0375-9393issn
1827-1596pii
R02Y9999N00A140830journal_volume
80pub_type
杂志文章abstract::On the basis of experience of 25 patients subjected to suspension laryngoscopy and bronchoscopy, it is shown that the technique of anaesthesiology conduction adopted responds to the needs of the anaesthesist and the laryngoscopist. Althesin in particular has been found to possess the requisites for this type of diagno...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1981-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the usefulness of the modified Harris-Benedict formula predicting Energy Expenditure (EE) in pressure support ventilated, critically ill patient. SETTING:The intensive care unit (ICU) of a teaching hospital. PATIENTS:Fiftyfive patients admitted to ICU for acute respiratory failure, requiring mec...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1996-05-01 00:00:00
abstract:BACKGROUND:Devices that limit microaspiration through the cuffs of endotracheal tubes could help prevent ventilator-associated pneumonia (VAP). The amount of tracheal microaspirations could be a relevant study endpoint. The aim of our study was to assess whether amylase measured in tracheal secretions constituted a rel...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2013-09-01 00:00:00
abstract::Excessive adrenergic stimulation may be associated with several adverse events and contribute to increase mortality in critically ill septic patients. Few clinical data exist on the effects of adrenergic blockade in this setting. The objective of this study was to investigate the effect of a short acting b-blocker (es...
journal_title:Minerva anestesiologica
pub_type: 评论,杂志文章
doi:
更新日期:2014-02-01 00:00:00
abstract::Bowel dysfunction, especially ileus, has been increasingly recognized in critically ill patients. Ileus is commonly associated to constipation, however abnormal motility can also concern the upper digestive tract, therefore impaired gastrointestinal transit (IGT) seems to be a more appropriate term. IGT, especially co...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.20.14778-3
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the incidence of colonization and infection by methicillin-resistant in PICU. DESIGN:Prospective cohort study during 2 years for the surveillance of nosocomial infections. SETTING:Four beds Pediatric Intensive Care Unit. PATIENTS:We studied two-hundred patients with duration of hospitalization ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1995-06-01 00:00:00
abstract::Surgery is currently the treatment of choice for acutely ruptured aneurysms, representing an efficient option both in the short and long term. We believe that the endovascular option may be of help in high surgical-risk cases. ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:Trapeziectomy is one of the most painful procedures in ambulatory surgery. This prospective randomized trial aimed to compare postoperative pain control using distal peripheral nerve blocks (dPNB) with a low concentration of a long-acting local anesthetic versus conventional systemic analgesia. METHODS:Fift...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:10.23736/S0375-9393.18.12291-7
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:The efficacy of an ultrasound guided transmuscular quadratus lumborum block (QLB) for perioperative analgesia of the upper and lower abdomen remain debatable. The purpose of this study was to compare the cutaneous sensory blocked area (CSBA) between QLB blocks performed at the L2 vs. L4 levels. METHODS:Twen...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:10.23736/S0375-9393.19.13656-5
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) are the most common causes of severe acute brain injury in younger Intensive Care Unit (ICU) patients. Dysglycemia (abnormal peak glycemia, glycemic variability, mean glycemia, nadir glycemia) is common in these patients but its comparative outco...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.19.13307-X
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Goal-directed fluid management using stroke volume variation (SVV) analysis is not well studied in free flap reconstruction surgery in patients with head and neck cancer. METHODS:Patients operated due to cancer of the head and neck with free flap reconstruction during 2008-2010 and 2012-2014 in Oulu Univers...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.16.11451-8
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:The analysis of the arterial pulse contour obtained by means of a non-invasive device (Finapres) seems to be an ideal method to measure cardiac output (CO). An individual calibration factor (Z) dimensionally equal to aortic impedence is the necessary pre-requisite to calculate CO by pulse contour analysis. T...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1998-03-01 00:00:00
abstract:BACKGROUND:Although blood gas analysis (BGA) is important for supplemental oxygen titration, it is invasive, intermittent, costly, and burdensome for staff. We assessed whether the Oxygen Reserve Index (ORi™), a novel pulse oximeter-based index that reflects the partial pressure of oxygen (PaO2), could determine the am...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.20.14895-8
更新日期:2020-12-15 00:00:00
abstract::With the first generation of ventilators, it was often necessary to sedate patients to avoid dyssynchrony between patient and ventilator. The standard treatment of patients in need of mechanical ventilation has therefore traditionally included sedation. Modern ventilators are able to simulate the patients breathing ef...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2011-01-01 00:00:00
abstract::A case of high spinal anesthesia complicating an interscalene brachial plexus block is described. After an apparently straightforward location of the plexus with good paresthesias, the injection of 10 ml of local anesthetic caused a high spinal block whose main feature was apnea. The patient retained his consciousness...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1980-03-01 00:00:00
abstract::Accidents during anaesthesia may be clinical or technical. To avoid the latter, stress is laid on the by no means new concept that techniques and handling must fit contingent requirements and that they may be dangerous as much for their inadequate as for their excessive use. ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND:No data are available on the perioperative approach during orthotopic liver transplantation (OLT) in Italy, apart from sporadically single center studies. METHODS:The Department of Anesthesia cooperating with each Italian licensed OLT center received a questionnaire regarding preoperative evaluation, intrao...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:To set up an index for the evaluation of type of interventions and procedures applied a prerequisite for the evaluation of appropriateness of ICU's activity. DESIGN:Observation prospective study. PATIENTS:2507 patients out of the 5030 enrolled in the cohort study. MEASUREMENTS:A cross-sectional assessment ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1997-11-01 00:00:00
abstract:AIM:Inguinal herniorrhaphy (IH) is a common surgical procedure that can be successfully performed by using general, regional or local anesthesia and is usually performed in an outpatient setting. In this study, recovery profile, incidence of adverse effects, postoperative pain scores and patient satisfaction between pa...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:Fiberoptic intubation is a core skill in anesthesiology. However, this complex psychomotor skill is challenging to learn in the clinical setting. The goal of this study was to evaluate the Virtual Fiberoptic Intubation (VFI) software as an adjunct to the traditional fibreoptic intubation teaching. METHODS:A...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2012-04-01 00:00:00
abstract::Stroke is a devastating complication that is difficult to diagnose in the perioperative setting because of the effects of anesthetic and analgesic agents. Lingering anesthesia effects hinder clinicians in identifying stroke symptoms, frequently resulting in a delay in diagnosis and treatment and in unfavorable outcome...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.17.11976-0
更新日期:2017-11-01 00:00:00
abstract::Cervical vertebral dislocations and fractures require the complete immobility of the neck until an intervention of stabilization of the spinal cord, by surgery or external means, is performed. Endotracheal intubation, which might represent a harmful operation, can become difficult when the stabilization of the spinal ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1989-03-01 00:00:00
abstract:OBJECTIVES:To review experience with anaesthetic management in patients undergoing a left ventricular assist system (LVAS) Novacor implant as a bridge to cardiac transplantation. DESIGN:Retrospective clinical study. SETTING:Cardiothoracic operating room in a university hospital. PATIENTS:Nine, aged 37-62 years, suff...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:Inhaled NO can improve arterial oxygenation in ARDS. We evaluated the incidence and the magnitude of this effect during a short test of NO inhalation. This was performed in 24 consecutive mechanically ventilated patients with ARDS in order to assess the interest of NO for the therapy of hypoxemia in each case...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1995-04-01 00:00:00
abstract:BACKGROUND:Combined epidural/general anaesthesia might theoretically emphasise the cardiovascular effects of epidural block alone. The goal of the present investigation was to evaluate the incidence of both hypotension and bradycardia during integrated epidural/general anaesthesia in a multicentric, observational study...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1998-07-01 00:00:00
abstract::The authors report the case of a patient suffering from central sleep apnea (CSA) who underwent neurosurgery for ventriculo-peritoneal derivation under general anesthesia. Given the risk of postoperative hypoventilation in CSA, intraoperative anesthesia was induced using remifentanyl, an opiate with a plasma half-life...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1999-09-01 00:00:00
abstract:INTRODUCTION:Although many drugs have been studied to prevent postoperative shivering, their comparative effectiveness is unknown. We attempted to assess the comparative effectiveness of the pharmacologic strategies to prevent shivering after surgery including intravenous (IV) and intrathecal (IT) meperidine, IV and IT...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,meta分析,评审
doi:10.23736/S0375-9393.18.12813-6
更新日期:2019-01-01 00:00:00
abstract::The term "chronic" is often used in daily clinical practice to indicate a type of pain that lasts over time and is accompanied by diagnostic and therapeutic difficulties. The common feeling is that in this category are actually collected many different clinical cases with the unique characteristic that the pain lasts ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2012-06-01 00:00:00
abstract::An account is given of the employment of althesin as an induction and maintenance anaesthetic. It is free of the drawbacks observed with thiopentone induction, and has negligible haemodynamic and respiratory effects. Its association with leptophen permitted excellent analgesia at minimal leptophen doses, without secon...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract:BACKGROUND:Surgical trauma inhibits cellular immunity. Dexmedetomidine produces opioid-sparing effect and an impact on immune response. METHODS:Eighty-six surgical patients were enrolled and received postoperative patient-controlled intravenous analgesia (PCIA) with either fentanyl alone (fentanyl group) or combined w...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.20.14581-4
更新日期:2021-01-12 00:00:00