预防性抗生素用于预防呼吸机相关肺炎:双向和贝叶斯网络元分析
Shanshan Zha1,2, Jianyi Niu1,2, Zhenfeng He1,2
1Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120, Guangdong, China.
预防性抗生素可能会降低在强症监护室 (ICU) 接受侵入性机械通风 (IMV) 患者的呼吸器相关肺炎 (VAP) 发生率. 喷雾式托布拉米辛和IV安培-苏尔巴克坦似乎是最有效的,但需要更多的研究.
科学领域:
- 临界护理医学 临界护理医学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 预防性抗生素在侵袭性机械通风 (IMV) 患者中预防呼吸机相关肺炎 (VAP) 的有效性需要进一步澄清.
- 这项研究解决了围绕在重症监护室 (ICU) 设置中的抗生素预防的不确定性.
研究的目的:
- 进行一个网络元分析,比较抗生素预防在预防ICU的IMV患者中VAP的疗效和安全性.
- 评估预防性抗生素对VAP发病率,死亡率和住院和ICU长度的影响.
主要方法:
- 在PubMed,Web of Science,Embase和Cochrane图书馆数据库中进行了全面的文献搜索,截至2021年12月.
- 包括的研究评估了预防性抗生素对VAP,死亡率和患者停留时间的影响.
- 用贝叶斯网络元分析来合成数据.
主要成果:
- 分析了13项涉及2144名患者的研究.
- 与对照组相比,预防性抗生素治疗显著降低了VAP率 (风险比率 = 0.62).
- 气溶液中的托布拉米辛和静脉注射的安皮cillin-sulbactam显示出最有可能成为最有效的VAP预防方案.
结论:
- 抗生素预防似乎可以降低VAP发病率,但不会影响ICU成人IMV患者的死亡率.
- 雾化托布拉米辛和静脉注射安皮西林-苏尔巴克坦显示出作为有效的VAP预防策略的希望.
- 需要进一步进行高质量的随机对照试验,以确定最终的临床建议.
更多相关视频
05:39Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
11:32Following in Real Time the Impact of Pneumococcal Virulence Factors in an Acute Mouse Pneumonia Model Using Bioluminescent Bacteria
Published on: February 23, 2014
相关概念视频
Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
Transmission-based Precautions II: Airborne and Protective Environment
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
Pneumonia III: Complications and Assessment
