[Bacterial flora of the respiratory tract in artificially ventilated patients]. / Flora bakteryjna dróg oddechowych u chorych sztucznie wentylowanych.

Patients treated in ICUs are at particular risk for nosocomial infections. Within this group a ventilator-associated pneumonia still constitutes a major problem. Highly virulent hospital strains, existing in ICUs, can colonize patients' upper respiratory tract. Therefore this study aimed at analysing the organisms found in patients who required mechanical ventilation in ICUs. The same types of bacteria with the same (high) rate colonized upper airways, trachea and stomach of patients treated at the intensive Care Unit. It is suggested that the presence of Gram negative bacilli may serve as a marker of possible pneumonia in artificially ventilated patients. It is also important to check whether the organisms isolated from the larynx or trachea are only colonizing agents or are representative for the etiologic factors of pneumonia. Antibiotic therapy based on the sensitivity tests could be inadequate.

Bioavailability of medication after laparoscopic cholecystectomy.

Bioavailability of medication after laparoscopic cholecystectomy has not been studied previously. There is concern about the ability of patients to tolerate oral medication postoperatively and the optimal timing of hospital discharge. In this study, each subject received 20 mg/kg acetaminophen (po) preoperatively, with a repeat dose at 6 (group 1), 12 (group 2), or 24 h (group 3) postoperatively. Serum levels were obtained 40 and 90 min after each ingestion. Bioavailability of medication was significantly decreased (p < 0.01) 6 h (group 1) and 12 h (group 2) postoperatively. Bioavailability returned to baseline by 24 h after laparoscopic cholecystectomy (group 3). This study indicates that oral medication should be used judiciously during the first 12 h after laparoscopic surgery.

Bioavailability of medication delivered via nasogastric tube is decreased in the immediate postoperative period.

BACKGROUND: A study was performed to determine bioavailability of medication delivered via nasogastric tube in patients after abdominal surgery. METHODS: Acetaminophen (20 mg/kg) was administered to each patient per os at least 48 hours prior to abdominal surgery and via nasogastric tube 3 hours postoperatively. The nasogastric tube was clamped for 30 minutes after drug administration, prior to resuming suction. Serum levels of acetaminophen were measured 0, 40, and 90 minutes after each dose. RESULTS: Acetaminophen levels were significantly lower (P < 0.001) when the drug was administered via nasogastric tube postoperatively. CONCLUSIONS: Decreased bioavailability of medications delivered via nasogastric tube may have important clinical implications and should be taken into consideration during the postoperative period.