RESUMO
Nephrotoxicity was assessed in 173 critically ill patients receiving intravenous colistin or polymyxin B; it occurred in 60.4% and 41.8%, respectively. Further investigation is necessary to elucidate the reason for the difference in nephrotoxicity observed between the groups and to assess the impact of severity of illness and dosing/administration.
Assuntos
Injúria Renal Aguda/induzido quimicamente , Injúria Renal Aguda/epidemiologia , Antibacterianos/efeitos adversos , Colistina/análogos & derivados , Polimixina B/efeitos adversos , Administração Intravenosa , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/administração & dosagem , Estudos de Coortes , Colistina/administração & dosagem , Colistina/efeitos adversos , Estado Terminal , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Polimixina B/administração & dosagem , Estudos Retrospectivos , Centros de Atenção TerciáriaRESUMO
PURPOSE: This study evaluated the efficacy of the HemCon Dental Dressing (HDD; HemCon Medical Technologies, Inc, Beaverton, OR) hemostatic oral wound dressing derived from the US military HemCon Bandage combat wound dressing and whether early hemostasis affects postoperative care and surgical healing outcomes following oral surgical procedures. PATIENTS AND METHODS: All patients aged 18 to 90, except those allergic to seafood, who consented to participate were eligible for enrollment into this study regardless of other medical history findings. All patients were required to have 2 or more surgical sites so they would have internal surgical control sites. All patients taking oral anticoagulation therapy (OAT) were included for treatment in this study without altering their anticoagulant medication regimens. All data were evaluated by biomedical statisticians and Institutional Review Board approval was obtained. RESULTS: All HDD surgically treated sites, including all from patients taking OAT, achieved hemostasis in less than 1 minute and control wounds in 9.53 minutes (P < .001). All HDD sites achieved hemostasis sooner than control sites (P <.001). Approximately 32% of HDD treated sites had significantly better healing compared with control sites (P <.020) and no control sites healed better than HDD treated sites; 32% of HDD treated oral surgery wounds achieved statistically significant improved healing (P <.001). All patients taking OAT achieved hemostasis within 1 minute and were treated without altering their anticoagulant regimens. Although the pain scores and incidence of alveolar osteitis were lower for the HDD-treated sites, these scores were not significantly different than control-treated sites. There was no negative healing sequela associated with early hemostasis of oral surgical wounds. CONCLUSION: The HDD has been proven to be a clinically effective hemostatic device that significantly shortens bleeding time following oral surgery procedures for all patients, including those patients taking OAT. Patients receiving the HDD had improved surgical wound healing compared with those receiving controls.