RESUMEN
Resuscitative bronchofibroscopy in victims with severe injury and aspiration has been shown to be both a method for diagnosing damages to the bronchus and lung and that for recovering airway patency in them. The most common involvement (47% of cases) in chest injury has been noted to be the lower lung with the development of pyoinflammatory processes caused by etiologically significant microorganisms, such as Staphylococcus aureus and types of Enterobacteriacea, in most cases (more than 50%).
Asunto(s)
Bronquitis/microbiología , Líquido del Lavado Bronquioalveolar/microbiología , Traumatismo Múltiple/complicaciones , Neumonía Bacteriana/microbiología , Aspiración Respiratoria/complicaciones , Adulto , Lavado Broncoalveolar , Broncoscopía , Femenino , Humanos , Unidades de Cuidados Intensivos , Masculino , Traumatismo Múltiple/microbiología , Aspiración Respiratoria/microbiología , Factores de Tiempo , Índices de Gravedad del TraumaRESUMEN
An analysis of 1458 case histories of patients with a combined trauma has shown that 276 of the patients died, the lethality was 18.9%. The severity of each injury was estimated by the AIS scale, the severity of combined traumas--by the ISS scale. The syndrome of mutual aggravation of injuries manifested itself most brightly in the cases where one or more main injuries were dangerous for life. Of the greatest importance was an addition of the closed chest trauma to the dominating injury that resulted in a greater number of bronchial-pulmonary complications. Severe damages of the loco-motor system increased the number of thrombo- and fat embolism.
Asunto(s)
Insuficiencia Multiorgánica/etiología , Traumatismo Múltiple/complicaciones , Estudios de Seguimiento , Humanos , Incidencia , Persona de Mediana Edad , Insuficiencia Multiorgánica/diagnóstico , Insuficiencia Multiorgánica/mortalidad , Traumatismo Múltiple/diagnóstico , Traumatismo Múltiple/mortalidad , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Federación de Rusia/epidemiología , Tasa de Supervivencia/tendencias , Índices de Gravedad del TraumaRESUMEN
The dependence of cell-mediated reaction to antigens on circulation and respiration in traumatic shock has been established in two groups (60 patients each) during resuscitation, using skin tests with 5 bacterial antigens (Ps. aeruginosa, E. coli, Proteus, tuberculin, staphylococcus). Patients with trauma and decompensation of vital body functions are at high risk of infectious complications, as they are characterized by anergy, i.e. the absence of cell-mediated reactions to antigens, which leads to a higher incidence of infectious complications in them. Skin tests with bacterial antigens serve as a reliable and simple method for identification of patients at high risk of infectious complications in intensive care units.
Asunto(s)
Antígenos Bacterianos/inmunología , Heridas y Lesiones/inmunología , Humanos , Pruebas CutáneasRESUMEN
To find out if the transfer of P. aeruginosa infection by droplet route is possible in resuscitation and intensive care units, the bacteriological study of air samples taken in different rooms of resuscitation units (altogether 234 air samples) was carried out with the subsequent identification and typing of isolated P. aeruginosa strains. In most cases (70.5%) the microbial contamination of the air in the main rooms of resuscitation units was found not to exceed 500 microbial cells per cu. m, and no P. aeruginosa strains were isolated. The identification and typing of six P. aeruginosa strains isolated from the air of an isolation ward for patients with infectious complications made it possible to find out intraspecific differences of these microorganisms, as all of them belonged to strains of different sero- and pyocinotypes. Thus, the results of these investigations indicate that the droplet route of the transfer of P. aeruginosa hospital infection is not characteristic of resuscitation and intensive care units, as no P. aeruginosa strains are isolated from the main rooms of such units; likewise, no circulation of this microorganism was observed in the air of an isolation ward for patients with infectious complications.
Asunto(s)
Infección Hospitalaria/transmisión , Unidades de Cuidados Intensivos , Infecciones por Pseudomonas/transmisión , Resucitación , Microbiología del Aire , Humanos , Aisladores de Pacientes , Pseudomonas aeruginosa/clasificación , Pseudomonas aeruginosa/aislamiento & purificación , Piocinas/clasificación , SerotipificaciónRESUMEN
The bacteriological survey of resuscitation and intensive care units has revealed the presence of P. aeruginosa strains in the microflora in 69.4% of cases. The circulation of 1-2 P. aeruginosa strains, identical in their serovar and pyocin type, is indicative of the presence of hospital infection and, therefore, the endogenous character of the contamination of patients. P. aeruginosa hospital strains are the main causative agents of infectious complications in the patients treated in resuscitation units.