Otitis Media in the Pediatric Intensive Care Unit: A Prospective Study

Derkay, Craig S.; Bluestone, Charles D.; Thompson, Ann; Kardatske, David

doi:10.1177/019459988910000408

Cited by 20 publications

(13 citation statements)

References 23 publications

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“…However, such reviews are justified when there is interest in attempting to summarize association measurements between risk factors and illness outcomes that, for ethical rea- ### > 0 but < 10 days of antimicrobial therapy and a four-point increase on the PRISM score; § Yes for parenteral nutrition and a fi ve-day increase in length of stay; § § Singh-Naz et al 73 -an increase of four points of the PRISM score was associated to a 1.5-fold greater risk of developing HAI (OR = 1.6; 95%CI: 1.5-1.7);…”

Section: Discussionmentioning

confidence: 99%

“…Abstracts for which there was no agreement as to the inclusion were analyzed jointly and the decision was made by consensus. Thus, 84 (80 articles and four theses) were ob-tained for detailed reading by the same two authors independently 27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,…”

Section: Methodsmentioning

confidence: 99%

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Risk factors for healthcare-associated infection in pediatric intensive care units: a systematic review

et al. 2009

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Risk factors for healthcare-associated infection in pediatric intensive care units: a systematic review

et al. 2009

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“…In intubated patients, mechanical ventilation can impair mucociliary function and mucus viscosity and can lead to eustachian dysfunction (2,4). In addition, hypocapnia that occurs because of mechanical ventilation inhibits spontaneous respiration and negatively affects the middle ear pressure (8,9).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Prevalence and Factors Affecting the Development of Middle Ear Effusion in Patients with Prolonged Intubation in Intensive Care Unit

Dizdar¹,

Dinç²,

Ulusoy³

et al. 2015

JAREM

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Objective: Monitorization of patients in intensive care units requires a multidisciplinary approach. As cooperation with unconscious or intubated patients is often not possible, some conditions may be overlooked. The aim of this study is to reveal the incidence and factors affecting otitis media with effusion in ICU patients intubated longer than 7 days.Methods: Twenty patients hospitalized in the intensive care unit of the Gaziosmanpaşa Taksim Training and Research Hospital from March to December 2014 were included in the study. The Gaziosmanpaşa Taksim Training and Research Hospital Ethics Committee approved the study according to the Declaration of Helsinki and Good Clinical Practices guidelines. All of the patients included in the study were aged ≥18 years. Patients intubated because of traffic accidents or trauma, patients with a history of chronic otitis media or ear, nose, and throat operations, patients with head and neck tumors, and patients with tympanic membrane perforation, external auditory canal pathology, nasopharyngeal mass, and chronic sinusitis as well as patients with a pathology leading to nasal obstruction, such as nasal polyposis or severe septal deviation, were excluded. After a detailed history by patients' relatives, an otoscopic examination, nasal examination, tympanometry, and acoustic reflex measurements were performed. Ear examination was performed using a conventional portable otoscope.Results: Among 20 patients, 12 had bilateral effusion (24 out of 40 ears, 60%). In two patients, a type C tympanogram was obtained (four out of 40 ears, 10%), and the remaining 12 ears of six patients were normal (30%). When intubation time is evaluated, among 13 patients intubated longer than 14 days, 11 had effusion (84%). A significant correlation was found between the duration of intubation and effusion development. Assessing the state of consciousness, 11 of 12 unconscious patients (91%) were found to have effusion. There was a significant correlation between effusion development and state of consciousness. Conclusion:In unconscious patients intubated longer than 14 days, the risk of having middle ear effusion is demonstrated to be higher. Consequently, in the periodic follow-up of intensive care patients with prolonged intubation, a routine otoscopic examination has to be considered. (JAREM 2015; 5: 64-7)

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“…Moreover, mechanical ventilation usually leads to moderate hypocapnia and inhibits spontaneous respiration. Hypocapnia affects middle ear pressure in a negative way (9). The second cause is that the patient's loss of consciousness or intake of sedative drugs contributes to the nasopharyngeal tube dysfunction by influencing the neuromuscular system or disrupting swallowing function, which causes negative middle ear pressure and effusion (7,9).…”

Section: Discussionmentioning

confidence: 99%

Middle Ear Pressure and Factors Affecting It in Intubated Patients Hospitalized in Intensive Care

Akdağ¹,

Cetin²,

Baysal³

et al. 2014

Turk Arch Otolaryngol

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Objective: To assess the probable agents affecting middle ear pressure in intubated patients hospitalized in intensive care units with various diagnoses.Methods: Middle ear pressure of 38 patients hospitalized in intensive care units within our faculty hospital was measured using portable tympanograms and acoustic reflectometry. The mode of the device to which each patient was attached and patients' blood pressure, Glasgow Coma Score, and additional disease parameters other than admission diagnosis were recorded. All data collected were subjected to statistical analysis to determine whether or not they affected middle ear pressure.Results: Septal deviation, survey, and mode of automatic respiratory device emerged as factors affecting middle ear pressure (odds coefficient 4.796, 3.745, 2.557, respectively, with 95% CI). Although aged over 60, additional disease and nasogastric tube also compromised middle ear pressure; the levels involved were not statistically significant. Conclusion:Middle ear pressure in patients hospitalized in intensive care units may change, particularly after the seventh day. This may particularly involve septal deviation, survey, and mode of automatic respiratory device, and tympanograms and reflectometry may be added to the patient-monitoring protocol in terms of changes in middle ear pressure.

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Otitis Media in the Pediatric Intensive Care Unit: A Prospective Study

Cited by 20 publications

References 23 publications

Risk factors for healthcare-associated infection in pediatric intensive care units: a systematic review

Risk factors for healthcare-associated infection in pediatric intensive care units: a systematic review

Evaluation of Prevalence and Factors Affecting the Development of Middle Ear Effusion in Patients with Prolonged Intubation in Intensive Care Unit

Middle Ear Pressure and Factors Affecting It in Intubated Patients Hospitalized in Intensive Care

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