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通过护理包预防呼吸机相关肺炎:系统性审查和元分析
Raquel Martinez-Reviejo1, Sofia Tejada1,2, Miia Jansson3,4
1Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid 28029, Spain.
呼吸机护理套件显著减少了呼吸机相关肺炎 (VAP) 发作和ICU的机械通风持续时间. 将这些捆绑与教育相结合,进一步改善了患者的治疗结果.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 医院流行病学 医院流行病学
背景情况:
- 呼吸器相关肺炎 (VAP) 是机械呼吸患者在医院获得的常见感染.
- 有效的预防策略对于改善患者的结果和降低医疗保健成本至关重要.
研究的目的:
- 系统地审查和元分析有关呼吸机护理包在预防VAP方面的有效性证据.
- 评估VAP预防包对VAP发病率,机械通风持续时间,停留时间和死亡率的影响.
主要方法:
- 随机对照试验和受控观察研究的系统审查和元分析.
- 纳入标准:成年人接受机械通风 (MV) 至少48小时.
- 在 MEDLINE,科克兰图书馆和科学网 (1985-2022) 中进行了搜索.
主要成果:
- 包括36项研究 (116,873名参与者);84,031人接受了VAP预防包.
- 呼吸器护理包显著减少了VAP发作 (OR=0.42,95% CI:0.33-0.54).
- 当与教育活动相结合时,包裹减少了MV持续时间和住院时间.
结论:
- 呼吸器护理套件有效地减少了成人ICU中的VAP发生率和机械通风持续时间.
- 将教育组件整合到护理包中可能会提高临床结果.
- 需要进一步的研究来澄清对死亡率的影响.
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