We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Success of countermeasures against respiratory infection after digestive surgery by strict blood and fluid resuscitation.
- Authors
Shinya Kusachi; Yoshinobu Sumiyama; Yoichi Arima; Yuichi Yoshida; Hidenori Tanaka; Yoichi Nakamura; Jiro Nagao; Yoshihisa Saida; Manabu Watanabe; Ryohei Watanabe; Junko Sato
- Abstract
Abstract This prospective controlled study included 5859 cases of digestive surgery from September 1987 to August 2002. The study was divided into six 2.5-year periods, A–F. During and after period B, cefazolin was used for surgery of the esophagus, stomach, and gall bladder, and cefotiam for colon resection, hepatectomy, and pancreatectomy. During period A, total parenteral nutrition (TPN) was administered for 6 (4.6) days before surgery, on average. During and after period B, TPN was confined to patients who were incapable of oral intake. During thoracic esophageal cancer surgery, frozen plasma was administered at 10 ml/h, colloid osmotic pressure was maintained, and water was prevented from accumulating in the third space. Mechanical respiratory support was not needed during or after period B. The incidence rate of respiratory infection decreased to 1.7% during period A, and to 0.7%–1.1% during and after period B. During and after period B, in particular, early respiratory infection cases after surgery decreased significantly to 0.1%–0.3%. In period A, among the respiratory infectious bacteria isolated, MRSA was the most frequent, followed by Pseudomonas aeruginosa. After period B, P. aeruginosa was the most frequent bacterium isolated. Over all periods, there was no significant difference in resistant ratios in P. aeruginosa. Because of consistent infusion management during the perioperative period, artificial breathing became unnecessary and, as a result, the prevalence of early respiratory infection decreased significantly.
- Subjects
DIGESTIVE system diseases; TOTAL parenteral feeding; ESOPHAGEAL cancer; RESPIRATORY diseases; RESPIRATORY infections
- Publication
Journal of Infection & Chemotherapy (Springer Science & Business Media B.V.), 2007, Vol 13, Issue 3, p172
- ISSN
1341-321X
- Publication type
Article
- DOI
10.1007/s10156-007-0514-Y