Nosocomial sinusitis nasotracheal intubation

Figure 2 Example of an intubated patient with continuous aspiration of subglottic secretions as reported by Valles and coworkers (29). Removal of subglottic secretions decreases colonization of the trachea and the risk of ventilator-associated pneumonia. This system has recently become available in the United States. Ideally, an endotracheal tube is preferred to a nasotracheal tube and placing the gastric tube through the mouth rather than the nose may reduce the risk of nosocomial sinusitis and pneumonia. (From Ref. 20, with permission.)...

Nasotracheal intubation and placement of a nasogastric tube are underappreciated risk factors for nosocomial sinusitis and VAP (128,147). The association between the development of sinusitis and VAP is difficult to demonstrate. However, the presence of sinusitis has been shown to be associated with a substantial increase in the number of nosocomial pathogens that are identified in patients with VAP. In a study by Rouby and coworkers, maxillary sinusitis, diagnosed by baseline and serial computer axial tomographic scan and needle... 

Holzapfel L, Chevret S, Madinier G, Ohen F, Demingeon G, Coupry A, et al. Influence of long-term oro- or nasotracheal intubation on nosocomial maxillary sinusitis and pneumonia results of a prospective, randomized, clinical trial. Crit Care Med 1993 21 1132-1138. 

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