Abstract：
PURPOSE:In mechanically ventilated patients, the endotracheal tube is an essential interface between the patient and ventilator, but inadvertently, it also facilitates the development of ventilator-associated pneumonia (VAP) by subverting pulmonary host defenses. A number of investigations suggest that bacteria colonizing the oral cavity may be important in the etiology of VAP. The present study evaluated microbial changes that occurred in dental plaque and lower airways of 107 critically ill mechanically ventilated patients. MATERIALS AND METHODS:Dental plaque and lower airways fluid was collected during the course of mechanical ventilation, with additional samples of dental plaque obtained during the entirety of patients' hospital stay. RESULTS:A "microbial shift" occurred in dental plaque, with colonization by potential VAP pathogens, namely, Staphylococcus aureus and Pseudomonas aeruginosa in 35 patients. Post-extubation analyses revealed that 70% and 55% of patients whose dental plaque included S aureus and P aeruginosa, respectively, reverted back to having a predominantly normal oral microbiota. Respiratory pathogens were also isolated from the lower airways and within the endotracheal tube biofilms. CONCLUSIONS:To the best of our knowledge, this is the largest study to date exploring oral microbial changes during both mechanical ventilation and after recovery from critical illness. Based on these findings, it was apparent that during mechanical ventilation, dental plaque represents a source of potential VAP pathogens.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Sands KM,Wilson MJ,Lewis MAO,Wise MP,Palmer N,Hayes AJ,Barnes RA,Williams DWdoi
10.1016/j.jcrc.2016.07.019subject
Has Abstractpub_date
2017-02-01 00:00:00pages
30-37eissn
0883-9441issn
1557-8615pii
S0883-9441(16)30323-9journal_volume
37pub_type
杂志文章abstract：PURPOSE:The purpose of this study is to examine the impact of hypernatremia acquired after intensive care unit (ICU) admission on mortality and length of stay (LOS). MATERIALS AND METHODS:Data for this observational study were collected from patients admitted between January 1, 2008, and September 30, 2010 to 344 ICUs...
journal_title：Journal of critical care
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更新日期：2019-02-01 00:00:00
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更新日期：1994-03-01 00:00:00
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pub_type： 杂志文章,多中心研究,随机对照试验
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journal_title：Journal of critical care
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journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2006.12.001
更新日期：2007-03-01 00:00:00
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更新日期：2009-03-01 00:00:00
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doi：10.1016/j.jcrc.2012.06.012
更新日期：2013-04-01 00:00:00
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journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2010.09.007
更新日期：2011-08-01 00:00:00
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pub_type： 杂志文章,meta分析
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更新日期：1994-06-01 00:00:00
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journal_title：Journal of critical care
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journal_title：Journal of critical care
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更新日期：2014-04-01 00:00:00
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更新日期：2013-02-01 00:00:00
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更新日期：2016-04-01 00:00:00
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pub_type： 杂志文章,随机对照试验
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更新日期：2014-02-01 00:00:00
abstract：:Hypernatremia is common in intensive care units. It has detrimental effects on various physiologic functions and was shown to be an independent risk factor for increased mortality in critically ill patients. Mechanisms of hypernatremia include sodium gain and/or loss of free water and can be discriminated by clinical ...
journal_title：Journal of critical care
pub_type： 杂志文章,评审
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更新日期：2013-04-01 00:00:00
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journal_title：Journal of critical care
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更新日期：2014-10-01 00:00:00
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journal_title：Journal of critical care
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更新日期：2018-02-01 00:00:00
abstract：PURPOSE:Lung ultrasound is an accurate and accessible tool to quantify lung edema. Furthermore, left ventricle filling pressures (LVFP) can be assessed with transthoracic echocardiography (TTE) by the E/e' ratio (E/e'). The present study aimed to assess the correlation between E/e' and lung edema quantified by a simpli...
journal_title：Journal of critical care
pub_type： 杂志文章
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更新日期：2018-04-01 00:00:00
