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Respir Med. 2012 Aug;106(8):1082-95. doi: 10.1016/j.rmed.2012.03.009. Epub 2012 Apr 20.

Ventilator-associated sinusitis in adults: systematic review and meta-analysis.

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Alfa Institute of Biomedical Sciences (AIBS), Athens, Greece.



To review the epidemiology, risk factors for, treatment and outcome of ventilator-associated sinusitis (VAS).


We performed a systematic review and meta-analysis of available data without time restrictions. A conservative random effects model was employed to calculate pooled odds ratios (OR) and 95% confidence intervals (CIs).


Out of 620 retrieved reports, 31 papers fulfilled our inclusion criteria. Infectious sinusitis affects 27% of mechanically ventilated patients and was found to be the cause of undetermined fever in 25% of the cases. Although radiographic VAS was higher in nasotracheally compared to orotracheally intubated patients (OR 4.66, 95% CI 1.35-16.13), clinical VAS was not (3.67, 0.80-6.81). The presence of VAS has been associated with the presence of VAP (3.66, 1.81-7.37) or bacteremia (6.85, 2.14, 21.92); however, it is unknown whether an etiologic relationship between them exists. In patients with concomitant VAS and VAP or bloodstream infections identical pathogens are isolated in 59% and 20% of the cases, respectively. The presence as opposed to absence of VAS was not associated with excess mortality (1.02, 0.35-3.01).


VAS is a common infection in critically ill adults and correlates with other important infectious complications.

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