Radiographic Mastoid and Middle Ear Effusions in Intensive Care Unit Subjects.
BACKGROUND: This study was conducted to determine the incidence of and risk factors associated with the development of radiographic mastoid and middle ear effusions (ME/MEE) in ICU patients. METHODS: Head computed tomography or magnetic resonance images of 300 subjects admitted to the University of...
| Publicado en: | Respiratory Care Vol. 62; no. 3; pp. 350 - 357 |
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| Autores principales: | , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Mar2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=121560502&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 121560502 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Mar2017 vid: 62 iid: 3 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 121560502 121560502 121560502 10.4187/respcare.05172 121560502 ppf: 350 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Radiographic Mastoid and Middle Ear Effusions in Intensive Care Unit Subjects. aug: au: Huyett, Phillip Raz, Yael Hirsch, Barry E. McCall, Andrew A. affil: Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania sug: subj: Intensive Care Units Mastoid Physiopathology Otitis Media with Effusion Risk Factors Incidence Ear, Middle Physiopathology Human Intubation, Gastrointestinal Intubation, Intratracheal Retrospective Design Temporal Bone Tomography, X-Ray Computed Magnetic Resonance Imaging Age Factors Length of Stay P-Value Intubation, Intratracheal Adverse Effects Data Analysis Software Chi Square Test T-Tests Logistic Regression Male Female Adolescence Young Adult Adult Middle Age Aged Aged, 80 and Over Odds Ratio Confidence Intervals Nasoenteral Tubes Sensitivity and Specificity Critically Ill Patients Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: BACKGROUND: This study was conducted to determine the incidence of and risk factors associated with the development of radiographic mastoid and middle ear effusions (ME/MEE) in ICU patients. METHODS: Head computed tomography or magnetic resonance images of 300 subjects admitted to the University of Pittsburgh Medical Center neurologic ICU from April 2013 through April 2014 were retrospectively reviewed. Images were reviewed for absent, partial, or complete opacification of the mastoid air cells and middle ear space. Exclusion criteria were temporal bone or facial fractures, transmastoid surgery, prior sinus or skull base surgery, history of sinonasal malignancy, ICU admission < 3 days or inadequate imaging. RESULTS: At the time of admission, 3.7% of subjects had radiographic evidence of ME/MEE; 10.3% (n = 31) of subjects subsequently developed new or worsening ME/MEE during their ICU stay. ME/MEE was a late finding and was found to be most prevalent in subjects with a prolonged stay (P < .001). Variables associated with ME/MEE included younger age, the use of antibiotics, and development of radiographic sinus opacification. The proportion of subjects with ME/MEE was significantly higher in the presence of an endotracheal tube (22.7% vs 0.6%, P < .001) or a nasogastric tube (21.4% vs 0.6%, P < .001). CONCLUSIONS: Radiographic ME/MEE was identified in 10.3% of ICU subjects and should be considered especially in patients with prolonged stay, presence of an endotracheal tube or nasogastric tube, and concomitant sinusitis. ME/MEE is a potential source of fever and sensory impairment that may contribute to delirium and perceived depressed consciousness in ICU patients. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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