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Bacteremia, Pneumonia, and Acute Renal Failure in Trauma Patients

  • M. Antonelli
  • M. L. Moro
  • G. Vivino
Part of the Yearbook of Intensive Care and Emergency Medicine book series (YEARBOOK, volume 1995)

Abstract

Trauma constitutes one of the main cause of death for the USA population in the first decades of life and the third cause of death in all age groups after cancer and atherosclerosis. Mortality from trauma has a multimodal distribution, with a first peak (few minutes after the traumatic event) produced by injuries of intrinsic lethal nature. The second peak (minutes to hours after the traumatic event) is produced by injuries of potentially lethal nature (neurologic injury or hemorrhage). Finally, the third peak (days or weeks) is due to sepsis and multiple organ failure (MOF) [1].

Keywords

Mechanical Ventilation Acute Renal Failure Trauma Patient Multiple Organ Failure Abdominal Trauma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Palter MD, Cortes V (1992) Secondary triage of the trauma patient. In: Civetta JM, Taylor RW, Kirby RR (eds) Critical Care. Lippincott, Philadelphia, pp 611–625Google Scholar
  2. 2.
    LaForce FM (1992) Lower respiratory tract infections. In: Bennett JV, Brachman PS (eds) Hospital acquired infections. 3rd edition. Little Brown and Co., Boston, pp 213–226Google Scholar
  3. 3.
    Weigelt JA (1985) Risk of wound infections in trauma patients. Am J Surg 150: 782PubMedCrossRefGoogle Scholar
  4. 4.
    Ledingham I, McAwatt I (1983) Influence of sedation on mortality in critically ill multiple trauma patients. Lancet 1: 1270PubMedCrossRefGoogle Scholar
  5. 5.
    Howard RJ, Simmons RM (1974) Acquired immunologic deficiencies after trauma and surgical procedure. Surg Gynecol Obstet 139: 771–775PubMedGoogle Scholar
  6. 6.
    Green GM, Jacob GL, Low RB, et al (1977) Defense mechanisms of the respiratory membrane. Am Rev Respir Dis 115: 479–485PubMedGoogle Scholar
  7. 7.
    Sleigh JD, Dich HM(1993) Problems of defective immunity: The diminished immune response. In: Wilson G, Miles A, Parker M (eds) Principles of bacteriology and immunity. Edward Arnold, London, pp 402–415Google Scholar
  8. 8.
    Gatell JM, Trilla A, Latorre X, et al (1988) Nosocomial bacteremia in a large Spanish teaching hospital: Analysis of factors influencing prognosis. Rev Infect Dis 10: 203–210PubMedCrossRefGoogle Scholar
  9. 9.
    Rello J, Quintana E, Mirelis B, Gurguì M, Net A, Prats G (1993) Polymicrobial bacteremia in critically ill patients. Intensive Care Med 19: 22–25PubMedCrossRefGoogle Scholar
  10. 10.
    Weinstein MP, Relier LB, Murphy JR, Lichtenstein KA (1983) The clinical significance of positive blood cultures: A comprehensive analysis of 500 episodes of bacteremia and fungemia in adults. II. Clinical observation with special reference to factors influencing prognosis. Rev Infect Dis 5: 54–69PubMedCrossRefGoogle Scholar
  11. 11.
    Bisbe J, Gatell JM, Puig J, et al (1988) Pseudomonas aeruginosa bacteremia: Univariate and multivariate analysis of factors influencing the prognosis in 133 episodes. Rev Infect Dis 10: 629–635PubMedCrossRefGoogle Scholar
  12. 12.
    Rello J, Ricart M, Mirelis B, et al (1994) Nosocomial bacteremia in a medical-surgical intensive care unit: Epidemiologic characteristics and factors influencing mortality in 111 episodes. Intensive Care Med 20: 94–98PubMedCrossRefGoogle Scholar
  13. 13.
    Moore FA, Moore EE, Poggetti R, Read R (1992) Post-injury shock and early bacteremia: A lethal combination. Arch Surg 127: 893–898PubMedCrossRefGoogle Scholar
  14. 14.
    Young RC, Bennett JE, Gelhoed G, Levine A (1974) Fungemia with compromised host resistance. Ann Intern Med 80: 605–612PubMedGoogle Scholar
  15. 15.
    Alexander JW, Boyce ST, Babcock GF, et al (1990) The process of microbial translocation. Ann Surg 212: 496–512PubMedCrossRefGoogle Scholar
  16. 16.
    Wilmore DW, Smith RJ, O’Dwyer ST, Jacobs DD, Ziegler TR, Wong XD (1988) The gut: A central organ after surgical stress. Surgery 104: 917–923PubMedGoogle Scholar
  17. 17.
    Antonelli M, Moro ML, Capelli O, et al (1994) Risk factors for early onset pneumonia in trauma patients. Chest 105: 224–228PubMedCrossRefGoogle Scholar
  18. 18.
    Marshall JC, Christou NV, Horn R, Meakins JL (1988) The microbiology of multiple organ failure. Arch Surg 123: 309–315PubMedCrossRefGoogle Scholar
  19. 19.
    Burch JM, Brock JC, Gervitzman L, et al (1986).The injured colon. Ann Surg 203: 701–711PubMedCrossRefGoogle Scholar
  20. 20.
    Scalea TM, Philips TF, Goldstain AS, et al (1988) Injuries missed at operation: Nemesis of trauma surgeon. J Trauma 28: 962–967PubMedCrossRefGoogle Scholar
  21. 21.
    Daniele RP (1980) Immunodefenses of lung. In: Fishman AP (ed) Pulmonary diseases and disorders. McGraw Hill, New York, pp 624–635Google Scholar
  22. 22.
    Craven DE, Steger KA (1989) Nosocomial pneumonia in the intubated patients. New concepts on pathogenesis and prevention. Surg Clin North Am 3: 843–866Google Scholar
  23. 23.
    Johanson WG, Pierce AK, Sanford JP (1969) Changing pharyngeal bacterial flora of hospitalized patients: Emergence of gram-negative bacilli. N Engl J Med 281: 1137–1140PubMedCrossRefGoogle Scholar
  24. 24.
    Craven DE, Kunches LM, Klinsky V, Lichtenberg DA, Make BJ, McCabe WR (1986) Risk factors for pneumonia and fatality in patients receiving continuous mechanical ventilation. Am Rev Respir Dis 133: 792–796PubMedGoogle Scholar
  25. 25.
    Mandelli M, Mosconi P, Langer M, Cigada M (1989) Prevention pneumonia in an intensive care unit: A randomized multicenter clinical trial. Crit Care Med 17: 501–505PubMedCrossRefGoogle Scholar
  26. 26.
    Mosconi P, Langer M, Cigada M, Mandelli M and I.C.U.G.I.C (1991) Epidemiology and risk factors of pneumonia in critically ill patients. Eur J Epidemiol 7: 320–327PubMedCrossRefGoogle Scholar
  27. 27.
    Torres A, Aznar R, Gatell JM, et al (1990) Incidence, risk and prognosis factors of nosocomial pneumonia in mechanically ventilated patients. Am Rev Respir Dis 142: 523–526PubMedCrossRefGoogle Scholar
  28. 28.
    Stoutenbeek CP, Van Saene HKF, Miranda DR, Zandstra DF, Langrehr D (1987) The effect of oropharyngeal decontamination using topical nonabsorbable antibiotics on the incidence of nosocomial respiratory tract infections in multiple trauma patients. J Trauma 27: 357–364PubMedCrossRefGoogle Scholar
  29. 29.
    Morris JA, Mucha P, Steven E, et al (1991) Acute post-traumatic renal failure: A multicenter prespective. J Trauma 31: 1584–1591PubMedCrossRefGoogle Scholar
  30. 30.
    Stene JK (1990) Renal failure in the trauma patient. Crit Care Clin 6: 111–119PubMedGoogle Scholar
  31. 31.
    Weinberger HD, Anderson RJ (1991) Prevention of acute renal failure. J Crit Care 6: 95–101CrossRefGoogle Scholar
  32. 32.
    Better OS (1990) The crush syndrome revisited (1940–1990). Nephron 55: 97–103PubMedCrossRefGoogle Scholar
  33. 33.
    Ron D, Taitelman U, Michaelson M (1984) Prevention of acute renal failure in traumatic rhabdomyolysis. Arch Intern Med 144: 277–280PubMedCrossRefGoogle Scholar
  34. 34.
    Harman PK, Kron IL, McLachlan HD, et al (1982) Elevated intra-abdominal pressure and renal function. Ann Surg 196: 594–597PubMedCrossRefGoogle Scholar
  35. 35.
    Shinozaki M, Mutoki T, Kaku N, Tsuda H (1988) Hemodynamic relationship between renal venous pressure and blood flow regulation during positive end-expiratory pressure. Crit Care Med 16: 144–147PubMedCrossRefGoogle Scholar
  36. 36.
    Voerman HJ, Stehouwer CD A, van Kamp GI, van Schijndel RJMS, Groenvald ABJ, Thijs LG (1992) Plasma endothelin levels are increased during septic shock. Crit Care Med 20: 1097–1101PubMedCrossRefGoogle Scholar
  37. 37.
    Guly UM, Turney JH (1990) Post-traumatic acute renal failure, 1956–1988. Clin Nephr 34: 79–83Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1995

Authors and Affiliations

  • M. Antonelli
  • M. L. Moro
  • G. Vivino

There are no affiliations available

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