是否可以实现零呼吸器相关肺炎? 更新了与呼吸机相关的肺炎预防的实践方法
Cristina Vazquez Guillamet1, Marin H Kollef2
1Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA.
Infectious disease clinics of North America
|December 1, 2023
概括
呼吸机相关肺炎 (VAP) 是一个常见的医院感染. 实施VAP预防包和使用自发呼吸试验是减少其发生的关键策略.
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:
- 呼吸机相关肺炎 (VAP) 影响7-15%的机械通风患者.
- VAP会导致显著的不良结果和增加医疗保健成本.
- 预防VAP是美国医院的强制性质量措施.
研究的目的:
- 审查和强调VAP预防策略的重要性.
- 突出VAP预防包的有效组成部分.
- 讨论自发呼吸和唤醒试验在减少VAP中的作用.
主要方法:
- 对VAP预防现有文献和临床指南的审查.
- 对常见的VAP预防捆绑组件进行分析.
- 评估支持自发呼吸和觉醒试验的证据.
主要成果:
- 预防VAP捆绑,包括床头升高,手部卫生,用赫西丁进行口腔护理和下沟排水,是有效的.
- 自发呼吸试验和唤醒试验显著缩短机械通风的持续时间.
- 减少机械通风持续时间与VAP发病率的次要下降有关.
结论:
- 综合性VAP预防包对于降低感染率至关重要.
- 将自发呼吸和唤醒试验纳入临床实践可以进一步减轻VAP风险.
- 多方面的方法对于在重症监护机构有效控制VAP至关重要.
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