ABSTRACT
Objective: Ventilator-associated pneumonia [VAP] is an infection with high mortality and morbidity that prolongs the length of stay in the intensive care unit [ICU] and hospitalisation. VAP is one of the most common infections in critically ill patients. This study aimed to prospectively determine the VAP rate and associated factors in critically ill patients with intensive antibiotic usage during a one-year period
Methods: In total, 125 out of 360 patients admitted to the intensive care unit during the one-year study period [September 2010-2011] were included for follow-up for VAP diagnosis. Demographic data, APACHE II scores, diagnoses on admission, clinical pulmonary infection scores [CPIS], CRP, procalcitonin, risk factors for infection, time to VAP diagnosis, and bacteriological culture results were recorded. All data were assessed in terms of ICU, hospital and 28-day mortality
Results: In total, 56 [45%] out of 125 patients were diagnosed with VAP. In addition, 91% of patients diagnosed with VAP were administered antibiotics before diagnosis. In the VAP patients, the mortality rates were 48, 68 and 71% for 28-day, ICU and hospital mortality, respectively
Conclusion: The coexistence of clinical and microbiological parameters should not be sought when diagnosing VAP in patients who use antibiotics intensively. VAP can be diagnosed when CPIS
Subject(s)
Humans , Male , Middle Aged , Aged , Intensive Care Units , Mortality , Prospective Studies , Anti-Bacterial Agents , Pneumonia , Critical IllnessABSTRACT
To compare the postoperative analgesic effects of intra-articular levobupivacaine with bupivacaine following knee arthroscopy. Forty patients, aged between 20-60 years and undergoing elective knee arthroscopy were enrolled into the study protocol that was carried out in Tepecik Education and Research Hospital, Izmir, Turkey between January and June 2007. General anesthesia protocol was the same in all patients. At the end of surgery, the patients were randomly assigned into 2 groups [n=20 in each group]. Group L received 20 ml 0.5% levobupivacaine and Group B received 20 ml 0.5% bupivacaine intra-articularly. We evaluated the level of postoperative pain [by visual analoque scale at 1, 2, 4, 6, 12, and 24 hours after surgery], first analgesic requirement time [period measured from the end of the surgery until further analgesia was demanded], and total analgesic consumption during 24 hours. There were no significant difference in the postoperative pain scores of the patients between groups. The first analgesic requirement times were not statistically different. Twelve patients in Group L [60%] and 9 patients in Group B [45%] needed no additional analgesic during the 24 hours [p > 0.05]. No complications and side effects were found related to the intra-articular treatment. The results of the study show that intra-articular 20 ml 0.5% levobupivacaine provides effective analgesia comparable to that provided by 20 ml 0.5% bupivacaine