呼吸道管理对呼吸机相关肺炎的影响:随机试验的证据
D Cook1, B De Jonghe, L Brochard
1Department of Medicine, St Joseph's Hospital and McMaster University, Hamilton, Ontario, Canada. debcook@fhs.csu.mcmaster.ca
JAMA
|March 21, 1998
概括
某些呼吸道管理策略可能会降低严重病患者的呼吸器相关肺炎 (VAP) 发生率. 诸如加湿器使用,输管部位和分泌液排水等因素会影响VAP风险.
科学领域:
- 关键护理医学 关键护理医学
- 肺部病理学 肺部病理学
- 传染性疾病 传染性疾病
背景情况:
- 呼吸器相关肺炎 (VAP) 是重症患者患病和死亡的重要原因.
- 许多干预措施旨在减轻VAP风险,强调需要基于证据的气道管理.
研究的目的:
- 系统地审查气道管理策略对VAP率的影响.
- 确定可能减少机械通风患者VAP发病率的具体干预措施.
主要方法:
- 1980年至1997年7月发表的随机试验的系统综述.
- 包括标准集中在影响VAP率的通风器电路和分泌物管理策略上.
- 数据抽象由两个独立的调查人员.
主要成果:
- 风扇电路的更改和吸气系统类型并没有显著改变VAP率.
- 较低的VAP率可能与避免加热加湿器,使用热和水分交换器,口腔输管,肠下分泌液排水和动力床相关.
结论:
- 特定的气道和分泌物管理技术可能会影响重症监护机构的VAP率.
- 这些策略的临床采用取决于证据,成本和可访问性.
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