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Papel da punção do seio maxilar no diagnóstico e no tratamento de pacientes com rinossinusite hospitalar / The role of maxillary sinus puncture on the diagnosis and treatment of patients with hospital-acquired rhinosinusitis
Mendes Neto, José Arruda; Guerreiro, Viviane Maria; Hirai, Elcio Roldan; Kosugi, Eduardo Macoto; Santos, Rodrigo de Paula; Gregório, Luis Carlos.
  • Mendes Neto, José Arruda; UNIFESP. EPM.
  • Guerreiro, Viviane Maria; UNIFESP. EPM.
  • Hirai, Elcio Roldan; UNIFESP. EPM.
  • Kosugi, Eduardo Macoto; UNIFESP. EPM.
  • Santos, Rodrigo de Paula; UNIFESP. EPM.
  • Gregório, Luis Carlos; UNIFESP. EPM. setor de Rinologia.
Braz. j. otorhinolaryngol. (Impr.) ; 78(4): 35-41, jul.-ago. 2012. ilus, tab
Article in Portuguese | LILACS | ID: lil-646768
RESUMO
A rinossinusite é uma das principais causas de febre em pacientes críticos e deve ser sistematicamente pesquisada.

OBJETIVO:

Avaliar o impacto da punção do seio maxilar à beira leito, no diagnóstico e no tratamento dos pacientes com rinossinusite infecciosa internados em Unidade de Terapia Intensiva de um hospital universitário de alta complexidade.

MATERIAIS E MÉTODOS:

Estudo retrospectivo que avaliou os pacientes em ventilação mecânica com febre de origem indeterminada e sinais tomográficos de rinossinusite submetidos à punção do seio maxilar pelo meato inferior.

RESULTADOS:

A amostra total do estudo consistiu de 27 pacientes (70,3% do sexo masculino com média de idade 45,3 anos). Os diagnósticos de admissão mais frequentes na Unidade de Terapia Intensiva foram Trauma Crânio Encefálico e Acidente Vascular Cerebral. No exame tomográfico, os seios paranasais mais acometidos foram o maxilar, em 85,2%, e esfenoidal, em 74,1%. A secreção purulenta foi visualizada no meato médio em 30,7% das fossas nasais. Os microrganismos mais frequentes nos aspirados dos seios foram Pseudomonas aeruginosa e Acinetobacter baumannii.

CONCLUSÃO:

A punção do seio maxilar à beira leito demonstrou-se uma importante ferramenta diagnóstica e terapêutica nos pacientes de UTI com rinossinusite hospitalar, submetidos à ventilação mecânica invasiva.
ABSTRACT
Rhinosinusitis is one of the most commom causes of fever of unknown origin in critically ill patients and should be systematically searched.

OBJECTIVE:

This study aims to evaluate the diagnostic and therapeutic effect of maxillary sinus puncture performed at the bedside in patients with infective rhinosinusitis hospitalized in an Intensive Care Unit of a high complexity care hospital. MATERIALS AND

METHODS:

This retrospective study looks into patients on mechanical ventilation with fever of unknown origin and signs of rhinosinusitis on CT images who were submitted to inferior meatus maxillary sinus puncture.

RESULTS:

The total study sample consisted of 27 patients (70.3% male; mean age 45.3 years). The most common Intensive Care Unit admission diagnoses were head trauma and stroke. CT scans revealed the maxillary (85.2%) and sphenoid (74.1%) sinuses were the most involved paranasal sinuses. Middle meatus purulent drainage was seen in 30.7% of the nasal cavities. Fever was reduced in 70.4% of the patients after puncture (p < 0.001). The most commonly found organisms in sinus aspirates were Pseudomonas aeruginosa and Acinetobacter baumannii.

CONCLUSION:

Maxillary sinus puncture performed at the bedside of the patients is an important diagnostic and theraupetic tool for critically ill patients.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Sinusitis / Rhinitis / Cross Infection Type of study: Diagnostic study / Observational study / Risk factors Limits: Female / Humans / Male Language: Portuguese Journal: Braz. j. otorhinolaryngol. (Impr.) Journal subject: Otolaryngology Year: 2012 Type: Article Affiliation country: Brazil

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Full text: Available Index: LILACS (Americas) Main subject: Sinusitis / Rhinitis / Cross Infection Type of study: Diagnostic study / Observational study / Risk factors Limits: Female / Humans / Male Language: Portuguese Journal: Braz. j. otorhinolaryngol. (Impr.) Journal subject: Otolaryngology Year: 2012 Type: Article Affiliation country: Brazil