在机械通风患者中使用单用和多用内管吸管:可行性随机对照试验
Mohamed H Eid1,2, Kevin Hambridge1, Patricia Schofield1
1School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, UK.
这项研究发现,在资源有限的ICU中,使用一次性或用赫西丁冲洗的内喉吸管是可行的. 这些策略可能有助于减少机械通风患者的呼吸器相关肺炎 (VAP).
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
- 卫生系统研究 卫生系统研究
背景情况:
- 单次使用的内吸管经常在资源有限的环境中被重复使用,对呼吸机相关肺炎 (VAP) 的影响尚不清楚.
- 关于在机械通风患者中重复使用开放的内吸管对VAP的影响的证据有限.
研究的目的:
- 评估一次性使用的可行性和多次使用的赫西丁冲洗的内喉吸管,以减少资源有限的重症监护病房 (ICU) 的VAP.
- 评估研究方法,为未来的最终随机对照试验 (RCT).
主要方法:
- 一个三臂可行性RCT,涉及60名机械通风患者在埃及三个ICU.
- 患者被随机分配到:干预I (一次性导管),干预II (用赫西丁冲洗的多次性导管) 或控制 (使用正常盐水的标准护理).
- 在6天内评估了可行性,坚持性和患者结果,包括VAP发病率.
主要成果:
- 实现了高招聘率 (96.7%) 和保留率 (93.3%),并100%遵守干预措施.
- 没有报告任何不良事件;赫西丁冲洗和一次性导管证明是实用的.
- VAP发生率为31.6% (干预I),26.3% (干预II) 和40% (对照). 与对照组相比,VAP的相对风险在干预I组为0.79%,在干预II组为0.66.
结论:
- 在资源有限的ICU中进行一次性使用和赫西丁冲洗导管的全面RCT用于VAP预防是可行的.
- 这些策略显示了减少VAP的潜力,并可以在资源有限的环境中为临床实践和感染控制提供信息.
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