New insights into the pathophysiology of aspiration pneumonia.

نویسندگان

  • A Guillon
  • J Montharu
  • B Cormier
  • L Vecellio
  • P Diot
  • M de Monte
چکیده

and emphasizes the need for careful history taking. As outlined in our editorial, there are several congenital bleeding disorders, including mild VWD, which may present with a completely normal coagulation screen and therefore may be missed unless a very careful history and clinical assessment is undertaken. As there actually was a clear personal and family history of bleeding in this case that would have led to coagulation testing if the patient had been aware of it, one has to ask if routine testing to identify an extremely small number of cases whereby the patient is unaware of the history is warranted, given the large number of tests needed. It also highlights the importance of how questions are asked, as members of families unaware of the symptoms of mild bleeding disorders may consider pronged bleeding after minor trauma or procedures such as cuts or dental extraction as ‘normal’. Specific questioning about duration of bleeding after minor trauma or procedures can clarify this. By and large, both the BCSH guidelines and NICE guidance reflect the uncertainties about establishing a bleeding tendency but also agree that a perioperative coagulation screen in most instances should not be performed routinely. Although one could make a better case for routine testing in patients awaiting surgery with a high bleeding risk, the arguments regarding poor sensitivity and specificity of these tests remain. In conclusion, we do not claim that history taking will entirely solve the problem of preoperative coagulation status but that it is more rational than relying on routine coagulation testing in unselected patients.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Aspiration pneumonia in dogs: pathophysiology, prevention, and diagnosis.

Aspiration pneumonia and aspiration pneumonitis are associated with significant morbidity in veterinary and human medicine. A variety of medical conditions and medications can predispose patients to aspiration, and every precaution should be taken to prevent aspiration from occurring. For dogs that aspirate oral or gastric contents and subsequently develop pneumonia, monitoring and supportive c...

متن کامل

The Danger of the Shedding Decidous Teeth Aspiration into the Bronchus and a Case Report of a Chronic Pneumonia in this Regard

The possibility of the shedding primary teeth aspirated into the bronchus is not taken into the consideration sofar as this matter could happen, particularly when it occurs without initial respiratory symptoms, or this episod may be forgotten. Tooth is a nonirritating foreign body and may produce few symptoms even after a prolonged time in the bronchus. Shedding primary teeth usually are only t...

متن کامل

بررسی بروز پنومونی بیمارستانی ناشی از آسپیراسیون در بیماران بستری در ‏بخشهای مراقبت ویژه در سال 1378

The objectives of this analytical-descriptive study were determinig the incidence of nosocomial pneumonia as a result of aspiration among the hospitalized patients in the intensive care units of Tehran university of medical sciences in 1999.For collecting data, the applied instruments consisted of: Glucose oxidase tape, thermometers, blood tests, chest radiography, culture from endotracheal sec...

متن کامل

Nosocomial Infection in Critically Ill Patient Receiving Stress Ulcer Prophylactic Drugs

     Acidic pH of stomach, which is a normal physiological barrier against bacterial overgrowth, would increase by stress ulcer prophylaxis initiation and may lead to bacterial colonization and play as a source for infection transmission to the respiratory system which results in ventilator related pneumonia in patients admitted to the Intensive Care Units (ICUs). Therefore, finding methods to ...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • British journal of anaesthesia

دوره 106 4  شماره 

صفحات  -

تاریخ انتشار 2011