欧洲专家就通过Delphi方法获得的与呼吸机相关的肺炎复发的定义达成共识:RECUVAP研究
Antoine Gaillet1,2, Charles-Edouard Luyt3,4, Jean-Francois Timsit5
1Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France. gaillet.antoine75@gmail.com.
本研究使用专家共识定义了复发性呼吸机相关肺炎 (VAP). 为了标准化诊断和改善临床试验比较,确定了四种不同的VAP复发类型.
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
- 临床微生物学 临床微生物学
背景情况:
- 存在初始呼吸器相关肺炎 (VAP) 的诊断标准,但对于复发的VAP缺乏定义.
- 在临床试验中对复发性VAP的不一致定义阻碍了研究的可比性.
- 标准化VAP复发定义对于准确的疗效评估至关重要.
研究的目的:
- 建立一个对VAP复发的共识定义.
- 定义和分类不同类型的VAP复发.
- 在临床实践和研究中促进一致的VAP复发评估.
主要方法:
- 使用了德尔菲方法,一个结构化的专家共识过程.
- 调查了36名专注于重症监护,传染病和微生物学的欧洲医生.
- 进行了四轮代,以达成专家一致意见.
主要成果:
- 达到了94%的专家一致认为,最初的VAP诊断标准可以应用于复发,在放射学标准上具有灵活性.
- 定义了四个不同的VAP复发实体:复发,持久VAP,超级感染和新病原体VAP.
- 基于细菌学发现,抗生素治疗时间和临床过程的不同复发类型;为持续VAP诊断提出的标准.
结论:
- 已经建立了一个基于共识的框架来对VAP复发进行分类.
- 拟议的定义旨在协调临床实践中的VAP复发标准.
- 标准化定义将提高未来VAP临床试验的可靠性和可比性.
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