Severely burned patients are at high risk of local and systemic infections due to skin barrier loss. Their clinical management is complex and requires coordinated intensive care and infection prevention strategies. Diagnosing infective endocarditis (IE) in this population is particularly difficult due to overlapping symptoms and limited diagnostic specificity. Common pathogens include Staphylococcus aureus, Pseudomonas aeruginosa, and Acinetobacter baumannii. We conducted a retrospective cohort study on 543 patients with burns affecting >18% of total body surface area (TBSA), admitted to our Burn Intensive Care Unit (BICU) from 2019 to 2024. The incidence of infective endocarditis was 1.47%, involving aortic (75%), mitral (12.5%), and tricuspid (12.5%) valves. Pathogens identified included S. aureus, Klebsiella pneumoniae, A. baumannii, and P. aeruginosa. This incidence is significantly higher than that in the general population. Mortality reached 50%, with an overall 3-month mortality of 75%. The literature on IE in burn patients is scarce, and the role of antibiotic prophylaxis remains controversial. Infective endocarditis in burn patients, although rare, represents a severe complication with high mortality. Early diagnosis and coordinated multidisciplinary care are essential to improve patient outcomes.
27 December 2024 in Translational Medicine @ UniSa
Introduction: Emergency upper gastrointestinal (GI) endoscopy is often prolonged and complex, performed during high-risk conditions. These procedures can be affected by an increased risk for airway compromise. Scarce literature can be found providing guidance on anesthesiological conduct during upper GI endoscopy in Emergency. Methods: This was a monocentric retrospective study conducted on 96 patients treated in the Emergency Gastroenterology Unit at AORN Cardarelli, between June and October 2023. Key features of moderate and deep sedation procedures were investigated. Results: There was no statistically significant difference in the incidence of complications and respiratory depression between the patients receiving moderate sedation versus those treated with deep sedation. Discussion: Adverse outcomes of sedation and analgesia during endoscopic procedures are rare, even during a deep state of sedation.