Kesser Bradley W, Woodard Charles Ryan, Stowell Nicholas G, Becker Samuel S
Department of Otolaryngology-Head and Neck Surgery, University of Virginia School of Medicine, 1 Hospital Dr., Old Medical School, Ground Floor, Charlottesville, VA 22908, USA.
Ear Nose Throat J. 2013 Aug;92(8):340-6. doi: 10.1177/014556131309200807.
We conducted a prospective study of 74 adults-34 men and 40 women, aged 18 to 90 (mean: 60.2)-to determine the prevalence of middle ear effusion (MEE) among patients in the setting of an intensive care unit (ICU) and to compare the findings with those of a control group of non-ICU hospitalized patients. Other goals were to identify risk factors associated with MEE in ICU patients and to evaluate any association with fever. Both groups included 37 patients. MEE was present in 19 patients (51.4%) in the ICU group, compared with only 2 patients (5.4%) in the control group (p < 0.01; odds ratio: 18.5; 95% confidence interval: 3.9 to 88.3). In the ICU group, there were statistically significant associations between MEE and both the use of mechanical ventilation (p = 0.03) and the use of sedation (p = 0.02). No significant relationships were seen in terms of length of stay, body position, the use of an endotracheal tube, the length of ventilation, and the use of a feeding tube. Fever was present in 8 ICU patients (21.6%) and 3 controls (8.1%), but none of the fevers was associated with MEE. We conclude that adult ICU patients have a high prevalence of MEE (51.4% in our sample) that is perhaps unrecognized. We believe that MEE in these patients is most likely related to altered consciousness, sedation, and mechanical ventilation. MEE was an unlikely cause of fever.
我们对74名成年人（34名男性和40名女性，年龄在18至90岁之间，平均年龄为60.2岁）进行了一项前瞻性研究，以确定重症监护病房（ICU）患者中耳积液（MEE）的患病率，并将研究结果与非ICU住院患者的对照组进行比较。其他目标是确定ICU患者中与MEE相关的危险因素，并评估与发热的任何关联。两组均包括37名患者。ICU组中有19名患者（51.4%）存在MEE，而对照组中只有2名患者（5.4%）存在MEE（p<0.01；优势比：18.5；95%置信区间：3.9至88.3）。在ICU组中，MEE与机械通气的使用（p=0.03）和镇静的使用（p=0.02）之间存在统计学上的显著关联。在住院时间、体位、气管内插管的使用、通气时间和饲管的使用方面未发现显著关系。8名ICU患者（21.6%）和3名对照组患者（8.1%）出现发热，但所有发热均与MEE无关。我们得出结论，成年ICU患者中MEE的患病率很高（我们样本中的患病率为51.4%），可能未被认识到。我们认为这些患者的MEE很可能与意识改变、镇静和机械通气有关。MEE不太可能是发热的原因。
