STUDY OBJECTIVES: To our knowledge, the predictors of @entity1576 ( @entity1576 ) and long-term mechanical ventilation have not previously been examined in @entity1 with wound @entity6938 associated with black tar heroin use. DESIGN: Retrospective case series. SETTING: A large university hospital. @entity1 : Twenty consecutive @entity1 from 1991 to 1998 with a diagnosis of wound @entity6938 associated with drug use as identified through chart records from a single institution. RESULTS: The predominant mode of drug use was subcutaneous (75%). Fifteen of 20 @entity1 (75%) developed @entity1576 . The clinical presentation was similar in groups with @entity1576 and without @entity1576 . Of those @entity1 who received antitoxin within 12 h of presentation, 57% required mechanical ventilation compared to 85% of @entity1 receiving the antitoxin after 12 h. The median durations of mechanical ventilation were 11 days for those who received antitoxin within 12 h, and 54 days for those who did not receive antitoxin within 12 h. The duration of mechanical ventilation for patients receiving antibiotics within 12 h was 35 days vs 54 days for patients receiving antibiotics after 12 h. Early tracheostomy (< 10 days after initial intubation) was associated with a shorter duration of mechanical ventilation (median, 45 days vs 60 days, respectively). CONCLUSION: Early antitoxin administration may decrease the need for and duration of mechanical ventilation among @entity1 with wound @entity6938 . Early tracheostomy may be beneficial for @entity1 with @entity1576 .

Clinical predictors of @entity1576 and long-term outcome in black tar heroin-associated wound XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS'] @entity1576 :: ('MESH:D012131', 'Disease') :: ['respiratory failure', 'RF'] @entity6938 :: ('MESH:D001906', 'Disease') :: ['botulism']
@entity6938 :: (MESH:D001906,Disease) :: ['botulism']
