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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A method is described for segmental esophageal replacement in dogs, with one of three types of tissue substitute: pericardium, fascia lata and aortic homograft. The experiments involving the thoracic esophagus failed owing to the development of acute mediastinitis and sepsis. The most promising results were obtained in animals in which an aortic homograft was used to replace the cervical sigment of the esophagus. Eight of the 12 animals with aortic homograft survived and gained weight until killed one to six months after operation. The overall results suggest that aortic homograft may have a potential clinical application in cases in which esophageal replacement is necessary.
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PMID:Expimental segmental replacement of esophagus by biological tissues. 85 64

Oesophageal perforations associated with cervical fractures occur from a variety of injuries. Fractures of the cervical spine, blunt trauma and penetrating injuries such as gunshot wounds, knives and missiles, perforate the cervical oesophagus. This retrospective study consists of 24 patients with an oesophageal perforation and cervical fracture. Motor vehicle accidents were responsible for 54% of the oesophageal perforations. The other oesophageal injuries were related to anterior spine surgery, gunshot wounds and sports-related activities. The clinical features related to these injuries included the obvious signs of an oesophageal perforation as well as fever of unknown origin, leukocytosis and unexplained persistent tachycardia. A variety of techniques was used to establish the diagnosis. All the patients had treatment for the cervical fracture and 20 patients required surgical repair of the oesophagus. The most common oesophageal complications were stricture of the oesophagus (54%) and oesophageal diverticulum (10%). The other complications were atelectasis, pneumonia, tracheobronchitis, pulmonary embolism, cervical osteomyelitis, cervical abscess, mediastinitis, septicemia and cervical fistulae. These patients have a serious life-threatening illness that may be difficult to diagnose and treat.
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PMID:Oesophageal trauma in patients with spinal cord injury. 128 44

The key problems of the theory of sepsis and criteria of its postmortem diagnosis are discussed on the basis of pathological and bacteriological study of about 4000 purulent-septic diseases observed for the last 40 years in the pathology department of N. V. Sklifosovsky Moscow Research Institute of Emergency Medical Aid (sepsis after abortion, surgical and iatrogenic sepsis, acute septic endocarditis, purulent peritonitis, mediastinitis, pleuritis, phlegmons of body and limbs, bacterial shock, etc.). Sepsis, according to the author, is a generalized infectious disease developing acyclically, produced mainly by purulent coccal flora and having the course of septicopyemia. A metastatic purulent focus is an obligatory sign of the generalization. Septicemia is a local inflammatory process produced mainly by bacterial gram-negative flora. It can be a prologue of sepsis but more frequently develops in two directions: 1) purulent-resorptive fever with an acute, subacute and chronic course; 2) bacterial shock with a fulminant course and high lethality.
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PMID:[Pathology and pathogenesis of sepsis]. 159 92

To investigate the effects of the hair removal methods and intraoperative irrigation on suppurative mediastinitis after cardiopulmonary bypass operations, 1,980 consecutive adult patients over a 2-year period in our institution were prospectively randomized to manual shaving versus electrical clipping of hair before the skin incision, and to povidone-iodine solution (0.5%) versus saline solution mediastinal and subcutaneous irrigation before wound closure. The overall incidence of suppurative mediastinitis was 0.86% (17/1,980). The infectious rate was significantly higher in the manually shaven (13/990) than in the electrically clipped patients (4/990) with an odds ratio of 3.25 (95% confidence interval, 1.11 to 9.32; p = 0.024). It was also higher in the povidone-iodine group (11/990) than in the saline group (6/990), although the difference was not statistically significant (p = 0.16). Fourteen patients were treated with operative debridement with closed tube irrigation, with one failure requiring a conversion to an open wound. Two patients were successfully treated with primary open wound procedures followed by delayed muscular flap closures, and 1 patient succumbed to rapid and profound sepsis soon after open drainage. We conclude that electrical clipping is superior to manual shaving in the prevention of suppurative mediastinitis. The routine use of povidone-iodine (0.5%) irrigation was of no benefit in this study and may increase the incidence of infection due to its known suppressive effects on local leukocytes and fibroblasts. Furthermore, operative debridement with closed tube irrigation was successful in treating the majority of cases in this series.
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PMID:Effects of shaving methods and intraoperative irrigation on suppurative mediastinitis after bypass operations. 173 72

We report a rare case of odontogenic abscess, detected while the patient was in the intensive care unit (ICU), which resulted in sepsis and the patient's death due to mediastinitis, skull osteomyelitis, and deep neck cellulitis. The detection of infectious focus in occult sepsis in ICUs is usually difficult because many diagnostic procedures cannot be conveniently performed. The use of 99mTc-hexamethylpropyleneamineoxime-labeled white blood cells scan allowed accurate diagnosis and appropriate surgical drainage.
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PMID:Spread of infectious complications of odontogenic abscess detected by technetium-99m-HMPAO-labeled WBC scan of occult sepsis in the intensive care unit. 173 49

Ludwig's angina is a cellulitis frequently occurring as a result of infections of the second and third lower molar. Despite a decrease in mortality from 50% to less than 10% since the introduction of antibiotics, it remains a rare but life-threatening illness. The potential for rapid respiratory obstruction is the greatest concern. Familiarity with the anatomy of the neck and recognition of symptoms are essential for effective treatment. Treatment focuses on maintenance of an airway, antibiotic therapy, and surgery. Asphyxia, aspiration, mediastinitis, pneumonia, empyema, and septicemia are possible complications.
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PMID:Ludwig's angina. 173 56

A closed system of percutaneous cardiopulmonary bypass (PCPB) with centrifugal pump and membrane oxygenator was applied for 2 patients with circulatory collapse caused by acute reclosure of left anterior descending coronary artery after PTCA in case 1 and acute myocardial infarction due to left main coronary artery lesion in case 2. Both patients were brought to operating room under the circulatory support of PCPB and successful coronary artery bypass was performed. Case 1 survived and case 2 died from sepsis due to mediastinitis inspite of satisfactory recovery of cardiac function. PCPB was confirmed as a useful method for emergency circulatory support and a bridge to cardiac surgery in patients with cardiogenic circulatory collapse.
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PMID:[Percutaneous cardiopulmonary bypass as a bridge to coronary artery bypass surgery in 2 cases of circulatory collapse caused by severe myocardial ischemia]. 189 93

Between 1984 and 1988, 12 mediastinitis were observed in a series of 1.724 cases of cardiac surgical procedures by sternotomy (0.7%). These 12 patients were retrospectively separated in 2 groups in terms of surgical management. In group I (5 patients in 1984 and 1985) the treatment was mediastinal irrigation and in case of failure, an omental transposition. In group II (7 patients in 1986, 86 and 88) the treatment was mediastinal irrigation and in case of failure, a mobilization of muscle flaps. Four patients died in group I of poly-visceral failure with a persistent severe sepsis. In group II, there was no death and the cicatrization was quickly obtained with an average length of stay in intensive care unit of 62 days. The mediastinal irrigation is the treatment of choice for benign mediastinitis, but the prognosis of severe mediastinitis was in our series greatly improved by muscle flap procedures realized with plastic and reconstructive surgical techniques.
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PMID:[Improvement in the prognosis of severe mediastinitis by the use of muscle flaps]. 201 33

The work analyses infectious complications after 35 orthotopic transplantations of the heart. The infectious complications are divided into 2 groups. Group 1 consisted of 6 patients with local complications. Group 2 was made up of 8 patients who died from bacterial infectious complications (mediastinitis 3, sepsis 2), from miliary tuberculosis of the lungs 1, cytomegaloviral infection 1, and systemic candidiasis 1.
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PMID:[Infectious complications following heart transplantation]. 201 67

Performing thoracic CT scanning in critically ill patients can be cumbersome and may have detrimental effects on the condition of the patient. We retrospectively analysed the clinical data of 46 patients who were examined over a period of 4.5 years. The thoracic CT scanning was judged useful in 40 patients (87%) and beneficial for 23 (50%) of these. The principal indications for the investigation are: suspected pulmonary abscess, suspected mediastinitis, precise localisation of an intrathoracic lesion prior to surgery, difficulty in the evaluation of the pulmonary parenchyma in patients with deforming thoracic kyphoscoliosis, suspected trapped pleural fluid and a suspected thoracic focus of sepsis. Transport had no detrimental effects on any of the patients. If the decision to undertake CT scanning is arrived at jointly by the radiologist and intensive care physicians, CT scanning is useful and can be performed safely if transport is undertaken by an experienced team.
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PMID:[The usefulness of thoracic computerized tomography in patients in an intensive care unit]. 202 6


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