Correlation of anthropometric index and cardiopulmonary exercise testing in children with pectus excavatum

BACKGROUND

Cardiopulmonary exercise testing (CPET) is a method used to evaluate functional impairment of patients with various diseases.

OBJECTIVE

The objective was to use CPET to estimate the usability of anthropometric index (AI) in patients with pectus excavatum (PE) as a marker of functional impairment caused by chest deformity.

METHODS

The study included 32 paediatric patients (28 males) with PE. Patients underwent CPET using a breath-by-breath exhaled gas analysis method and continuous monitoring of cardiac parameters.

RESULTS

In both groups, two (overall four) patients met criteria for cardiogenic limitation (low VO₂ and low O₂Pulse). Mean VO₂/WR was below two standard deviations (2SD) in patients with less severe PE; other observed parameters were within normal limits (Z-score ± 2 SD). The AI had no observed correlation with peak ventilation, VO₂peak and peak workload.

CONCLUSION

The obtained CPET data do not correlate well with the severity of chest deformity expressed with AI. There were similar physical activity limitations in both examined groups of patients and they did not depend on the severity of the deformity.

Device-associated nosocomial infection rates and distribution of antimicrobial resistance in a medical-surgical intensive care unit in Turkey

The aim of this study was to explore the rate of device-associated nosocomial infections (DANIs) and the distributions of causative agents and patterns of antibiotic resistance in the medical-surgical intensive care unit (ICU) over a 3-year period and to compare these rates with those reported by National Nosocomial Infections Surveillance System and International Nosocomial Infection Control Consortium. A total of 1,798 patients were hospitalized in our ICU for 13,942 days, of which 309 patients had DANIs, indicating an overall infection rate of 22.1 per 1,000 ICU-days. The central line-associated bloodstream infection rate was 6.4 per 1,000 catheter-days, whereas the ventilator-associated pneumonia rate was 14.3 per 1,000 ventilator-days and the catheter-associated urinary tract infection rate was 4.3 per 1,000 catheter-days. Overall, 87.4% of all Staphylococcus aureus DANIs were caused by methicillin-resistant strains. With respect to Pseudomonas aeruginosa, 30.9% of the strains were resistant to ciprofloxacin, 23.3% to amikacin, 43.1% to ceftazidime, 19.1% to piperacillin-tazobactam, and 34.7% to imipenem. Furthermore, 1.9% of the Enterococcus spp. were resistant to vancomycin, and 51.1% of Enterobacteriaceae were resistant to ceftriaxone. DANI rates decreased over the 3-year study period, which was likely in response to the infection control measures implemented in our ICU.