Abstract BOOK SIAART

INTRODUCTION. Dental injury occurres in 0.06 - 0.13 % of general anesthesia procedures re- quiring endotracheal intubation, and it is still a reason of complaint against anesthetists. Maxil- lary central incisors are the most commonly teeth injured.1 In our center claims related to teeth damage after intubation ended with a total reimbursement of 13.000 Euros (2014-2015) and 5 patients (2014 to June 2016) were admitted for cares in Prosthodontics Implant dentistry dept. Dental School - Turin. BUCX et al.2 used a strain gauge based sensor between handle and blade of the laryngoscope to measure forces applied on the maxillary incisors to show that during routine laryngoscopy great forces are exerted on the maxillary incisor teeth with no differences based on the operator experience. OBJECTIVES.The aim of this study is to measure of the forces applied on teeth using a direct laryngoscope or a McGRATH® videolaringoscope. Many authors described how lower force on soft tissue could be applied using a VLS (GlideScope) instead of a standard laryngoscope (P=0.05).3, but no studies have ever been performed involving the use of a force sensor directly applied on teeth. The aim of our study is to measure the forces applied on teeth after the application of a cus- tomized bite (2 mm dental bite) applied on the manikin. Anesthesiologists and anesthesia residents from “Città della Salute e della Scienza”,Turin will be asked to perform 3 intubations using the standard intubation system, and other 3 using McGRATH® videolaringoscope in order to test the intubation forces exerted

Antibiotic Prophylaxis to Reduce Respiratory Tract Infections and Mortality in Adults Receiving Intensive Care

BACKGROUND: Pneumonia is an important cause of mortality in intensive care units (ICUs). The incidence of pneumonia in ICU patients ranges between 7% and 40%, and the crude mortality from ventilator-associated pneumonia may exceed 50%. Although not all deaths in patients with this form of pneumonia are directly attributable to pneumonia, it has been shown to contribute to mortality in ICUs independently of other factors that are also strongly associated with such deaths. OBJECTIVES: To assess the effects of prophylactic antibiotic regimens, such as selective decontamination of the digestive tract (SDD) for the prevention of respiratory tract infections (RTIs) and overall mortality in adults receiving intensive care. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2009, issue 1), which contains the Cochrane Acute Respiratory Infections (ARI) Group's Specialised Register; MEDLINE (January 1966 to March 2009); and EMBASE (January 1990 to March 2009). SELECTION CRITERIA: Randomised controlled trials (RCTs) of antibiotic prophylaxis for RTIs and deaths among adult ICU patients. DATA COLLECTION AND ANALYSIS: At least two review authors independently extracted data and assessed trial quality. MAIN RESULTS: We included 36 trials involving 6914 people. There was variation in the antibiotics used, patient characteristics and risk of RTIs and mortality in the control groups. In trials comparing a combination of topical and systemic antibiotics, there was a significant reduction in both RTIs (number of studies = 16, odds ratio (OR) 0.28, 95% confidence interval (CI) 0.20 to 0.38) and total mortality (number of studies = 17, OR 0.75, 95% CI 0.65 to 0.87) in the treated group. In trials comparing topical antimicrobials alone (or comparing topical plus systemic versus systemic alone) there was a significant reduction in RTIs (number of studies = 17, OR 0.44, 95% CI 0.31 to 0.63) but not in total mortality (number of studies = 19, OR 0.97, 95% CI 0.82 to 1.16) in the treated group. AUTHORS' CONCLUSIONS: A combination of topical and systemic prophylactic antibiotics reduces RTIs and overall mortality in adult patients receiving intensive care. Treatment based on the use of topical prophylaxis alone reduces respiratory infections but not mortality. The risk of resistance occurring as a negative consequence of antibiotic use was appropriately explored only in one trial which did not show any such effect