与中线相关的和主要的血流感染
Adam G Stewart1, Kevin B Laupland2,3, Alexis Tabah1,2,4
1Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Royal Brisbane and Women's Hospital Campus, Brisbane.
Current opinion in critical care
|August 29, 2023
概括
导管相关的血流感染 (CA-BSI) 在ICU中很常见,影响患者的治疗结果. 有效的预防包和迅速的导管切除对于降低死亡率和改善重症患者的护理至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
- 流行病学 流行病学
背景情况:
- 主要和血管内导管相关的血流感染 (CA-BSI) 是重症监护室 (ICU) 发病率和死亡率的重要原因.
- 了解这些感染的流行病学和管理对于改善重症患者患者的治疗结果至关重要.
研究的目的:
- 在ICU背景下审查关于CA-BSI和其他原发性血液感染 (BSI) 流行病学和管理的最新数据.
- 综合当前关于严重病患者中BSI的流行率,风险因素和有效干预措施的研究结果.
主要方法:
- 对ICU中CA-BSI和初级BSI最近发表的文献进行系统审查.
- 对流行病学数据的分析,包括患病率,风险因素和死亡率的关联.
- 评估当前的管理策略和预防措施.
主要成果:
- 在重症患者中,初级BSI和CA-BSI的综合患病率分别为所有BSI的19.7-40.7%和26.4-37.3%.
- 源控制失败 (导管切除) 与死亡率增加有关;较高的严重性得分和更长的ICU停留时间是已知的CA-BSI风险因素.
- 中枢静脉线插入的预防包可以显著降低CA-BSI发病率 (每1000个导管日中有4至1.6);差异性时间到阳性可能有助于诊断.
结论:
- 主要BSI在ICU队列中普遍存在,并对结果产生负面影响.
- 在ICU中对BSI的监测对于医疗保健规划,预防策略,耐药性跟踪和病原体检测至关重要.
- 实施基于证据的预防包,并确保及时控制源是管理CA-BSI和改善患者存活率的关键.
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