鼻腔和呼吸机相关的肺炎
Carlos Cabanillas Díez-Madroñero1, Beatriz Raboso Moreno2,3, Blanca Urrutia-Royo4
1Pulmonology Department, Dr. Josep Trueta University Hospital of Girona, and Santa Caterina Hospital of Salt, Girona, Spain.
鼻腔肺炎 (NP) 和呼吸机相关肺炎 (VAP) 是严重的医院感染. 本综述指导临床医生管理NP/VAP,重点关注多药耐药生物 (MDRO) 和优化抗生素使用.
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
- 肺部病理学 肺部病理学
背景情况:
- 鼻腔肺炎 (NP),包括呼吸机相关肺炎 (VAP),显著增加患者的发病率,死亡率和医疗保健费用.
- 管理因多药耐药生物体 (MDROs) 的增加而复杂化.
研究的目的:
- 提供NP和VAP的流行病学,病理生理学和管理的全面审查.
- 专注于MDRO所带来的挑战,并指导临床决策.
主要方法:
- 综合当前的证据通过一个问题和答案格式.
- 对国际指导方针进行批判性评估 (IDSA/ATS,ERS,SEPAR).
- 对诊断工具,新型抗微生物药物和治疗持续时间策略的审查.
主要成果:
- 对于MDROs的危险因素包括长时间的通风和先前的抗生素暴露,需要风险分层.
- 快速的分子诊断可以提高产量和抗菌药物管理.
- 通常建议服用7-8天的抗生素疗程,并使用prokalcitonin帮助停止治疗的决定.
结论:
- 有效管理NP/VAP需要了解MDRO风险因素,并利用诊断工具.
- 在抗药性时代,优化抗微生物选择和持续时间至关重要.
- 本综述是为临床医生管理复杂病例提供基于证据的参考.
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