Hepatitis B Virus (HBV)

Category: Surgical ICU

Pulmonary Infiltrates in the Surgical ICU: Concusion

Pugin et al have developed a clinical pulmonary infection score that combines six different individually weighted clinical indexes to determine the likelihood of pneumonia; its predictive value for the diagnosis of pneumonia approached that of bronchoscopic criteria. However, in the study by Pugin et al, the sample size was small; 13 patients with pneumonia were […]

Pulmonary Infiltrates in the Surgical ICU: Outcome

These data have implications for the election of empiric antibiotic therapy for patients with pneumonia in the ICU. Patients with pneumonia upon admission to the ICU or shortly thereafter are likely to have a community-acquired pneumonia pathogen, particularly if they are immunocompetent. Thus, ampicillin-sulbactam or a second-gene ration cephalosporin such as cefuroxime alone, as recommended […]

Pulmonary Infiltrates in the Surgical ICU: Pneumococcal carriage

Haemophilus and pneumococcal carriage is common in healthy patients in the community. Trauma patients, unlike patients with chronic illnesses admitted to the ICU, are previously healthy. A lower incidence of Haemophilus/pneumococcal pneumonia in patients with chronic illnesses (and therefore prior or prolonged hospitalizations) may be reflective of the modification of the resident flora of the […]

Pulmonary Infiltrates in the Surgical ICU: Discussion

It has been suggested that different ICU patient populations may have different risks for nosocomial pneumonia. In one study, patients with cardiotho-racic surgery were more likely to have ventilator-associated pneumonia than medical patients. We found that different ICU populations not only have unique predispositions to particular types of pulmonary infiltrates, but the causative agent for […]

Pulmonary Infiltrates in the Surgical ICU: Mortality

The following variables were significant predictors of mortality at 30 days (Table 3): male gender (p = 0.021), renal disease (p = 0.003), liver disease (p = 0.0001), absence of ulcer prophylaxis (p = 0.01), absence of enteral nutrition (p = 0.014), inotropic support (p = 0.0001), vasopressor support (p = 0.0001), lower hematocrit (p […]

Pulmonary Infiltrates in the Surgical ICU: Extrapulmonary Infections

Extrapulmonary Infections Extrapulmonary infections occurred in 18% (7/39) of the patients with pneumonia, 24% (9/37) with edema, 20% (5/19) with acute lung injury, and 18% (3/17) of the patients with atelectasis. Bacteremia was observed in 7 of 39 patients with pneumonia and included 4 patients with MRS A, 1 with Enterobacter cloacae, and 1 with […]

Pulmonary Infiltrates in the Surgical ICU: Nosocomial Pneumonia in the ICU

A vast majority of the nonpneumonic pulmonary infiltrates were also in ventilated patients; 89% of acute lung injury, 88% of atelectasis, 70% of edema, and 75% of the contusion cases were in ventilated patients. Nosocomial Pneumonia in the ICU For this analysis, overt community-acquired pneumonias, ie, those occurring < 72 h after hospitalization, were excluded. Thirty-three of […]

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