Odontogenic mediastinitis: intensive therapy experience (clinical observation)

Abstract

Mediastinitis as complications of traumas and esophagus perforations are ill-controlled and characterized with high mortality. Yet clinical characteristics and therapeutic controllability of contact odontogenic mediastinitis are not covered enough in medical literature. Aim of the study was to investigate clinical characteristics and to analyze treatment results of odontogenic purulent mediastinitis according to data of pilot monocenter observational study. Material and methods. The results of treatment of the patients with odontogenic mediastinitis were analyzed in groups: panmediastinitis (8 participants) and posterior upper mediastinitis (12 participants). The following indexes were compared: body temperature, content of C-reactive protein, leucocytes, thrombocytes, creatinine, 24-hour and cumulative fluid electrolyte balance reproduced in hospitals of any equipment levels with using of criteria of nonparametric statistics for excluding of false positive results. Results. Causative agents of the infectious process were found in 65 % of patients in bacteriological study. The mortality was 5 %; the process controllability in conditions of described techniques of anesthesiology and intensive therapy has been shown, the danger of infusive overload of the interstitium of the lungs has been demonstrated.