消化道的选择性消毒:概念和应用
Eva Esther Tejerina-Álvarez1, Miguel Ángel de la Cal López2
1Department of Intensive Care Medicine, Hospital Universitario de Getafe, Carretera de Toledo, Getafe, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain.
Medicina intensiva
|October 20, 2023
概括
选择性消化道去污染 (SDD) 预防感染,降低重症监护病房的死亡率. 这种策略具有成本效益,安全,并且尽管使用不足,但不会增加抗菌素耐药性.
科学领域:
- 关键护理医学 关键护理医学
- 预防传染病 预防传染病
- 微生物学 微生物学
背景情况:
- 肠道中的细菌过度生长是重症监护室 (ICU) 感染的前身.
- 选择性消化道去污染 (SDD) 作为预防措施,针对这种过度生长.
- 尽管有证据表明,SDD在重症监护机构中尚未得到广泛实施.
研究的目的:
- 审查支持选择性消化道去污染 (SDD) 的证据.
- 更新与SDD感染控制相关的病理生理学概念.
- 鼓励在重症监护病房中更广泛地采用SDD.
主要方法:
- 现有科学文献的叙述性审查.
- 对重症患者感染的病理生理机制的分析.
- 对SDD有效性和安全性的临床试验数据的评估.
主要成果:
- SDD有效地预防严重感染,并降低了ICU患者的死亡率.
- 该策略具有成本效益,并且没有显著的不利影响.
- 抗微生物耐药性的显著增加与SDD的短期或长期使用无关.
结论:
- SDD对于重症患者来说是一种安全有效的干预措施.
- SDD的好处,包括减少感染和死亡率,得到了充分的证据支持.
- 增加SDD的实施是有必要的,以改善ICU患者的治疗结果.
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