Meyer P, Guerin J M, Habib Y, Levy C
Medical Intensive Care Unit, Lariboisière's Hospital, Université Paris VII.
Eur Respir J. 1988 Oct;1(9):868-9.
Three cases of Pseudomonas thoracic empyema occurring in nasotracheally intubated patients are reported. Paranasal rhinosinusitis, a well documented complication of prolonged nasotracheal intubation, could be the primary infectious location. Massive respiratory tract colonization leads to extensive necrotizing pulmonary lesions. Failure of diagnosis and treatment of sinus involvement could be responsible for persistent or recurrent pleural empyema. Treatment includes continuous pleural drainage, sinusitis treatment and antibiotics. This complication should be considered in the choice between early tracheostomy and prolonged nasotracheal intubation in Intensive Care Unit (ICU) patients.
本文报告了3例经鼻气管插管患者发生的铜绿假单胞菌性胸腔积脓病例。鼻旁鼻窦炎是长期经鼻气管插管的一种有充分文献记载的并发症，可能是主要的感染部位。大量呼吸道定植导致广泛的坏死性肺部病变。鼻窦受累的诊断和治疗失败可能是持续性或复发性胸腔积脓的原因。治疗包括持续胸腔引流、鼻窦炎治疗和使用抗生素。在重症监护病房（ICU）患者中选择早期气管切开术还是长期经鼻气管插管时，应考虑到这种并发症。
