在孟加拉国的一个重症监护室,基于证据的做法可以预防呼吸机相关的肺炎
Nahida Akhter1, Xintong Zhou1, Sameh Elhabashy2
1Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan.
Healthcare (Basel, Switzerland)
|November 13, 2025
概括
实施基于证据的实践 (EBP) 捆绑措施显著降低了孟加拉国ICU的呼吸机相关肺炎 (VAP) 发病率. 虽然VAP下降,但整体ICU死亡率增加,表明需要更广泛的重症监护改进.
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
- 护理实践 护理实践
背景情况:
- 呼吸机相关肺炎 (VAP) 是重症监护室 (ICU) 中死亡的重要原因,特别是在低收入和中等收入国家 (LMICs).
- 孟加拉国有限地实施基于证据的实践 (EBP) VAP包,阻碍了有效的预防.
- 本研究评估了EBP在减少孟加拉国成人ICU患者中VAP发病率方面的有效性.
研究的目的:
- 评估基于EBP的VAP捆绑干预措施在减少孟加拉国ICU中的VAP发病率方面的有效性.
- 在干预的背景下,确定与VAP发生率和患者结局相关的因素.
主要方法:
- 使用了具有历史控制组的准实验性设计.
- 该研究包括347名符合条件的ICU患者,其中一个干预组接受护士培训,学习VAP捆绑实践和先进设备.
- 收集的数据包括VAP发生率,VAP相关的患者结局和后勤回归分析.
主要成果:
- 与对照组 (46.1%) 相比,干预组 (26.9%) 的临床怀疑VAP发生率显著下降.
- VAP捆绑实施与减少VAP (Exp(B) = 0.417相关,而长时间通风 (≥96小时) 是一个风险因素 (Exp(B = 2.6).
- 早期发病的VAP下降,但晚期发病的VAP在干预组中仍然占主导地位.
结论:
- 由训练有素的护士实施基于EBP的VAP捆绑实施有效地减少了孟加拉国ICU的VAP发病率.
- 整体ICU死亡率的增加需要全面改善重症监护,包括并发症管理.
- 该研究证实了LMICICICU中VAP捆绑实施的可行性和有效性.
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