|
|
Abstruct: Ventilator-associated pneumonia (VAP) is a common cause of morbidity, antibiotic use, increased length of stay and, possibly,increased mortality in ICU patients. Colonization of the oropharyngeal cavity with potentially pathogenic micro-organisms is instrumental in the pathogenesis of VAP, and selective oropharyngeal decontamination (SOD) with antibiotics (AB-SOD) or antiseptics,such as chlorhexidine gluconate (CHX-SOD), has been associated with reduced incidences of VAP. In a recent issue of Critical Care Scannapieco and colleagues investigated differences in oropharyngeal colonization between mechanically ventilated patients receiving oropharyngeal decontamination with 0.12% CHX-SOD either once or twice daily compared to placebo. CHX-SOD was associated with a reduction in Staphylococcus aureus colonization,but the study was underpowered to demonstrate a reduction in VAP incidence. We urgently need well-designed and adequately powered studies to evaluate the potential benefits of CHX-SOD on patient outcome in ICUs.
In summary, the evidence that both AB-SOD and CHX-SOD reduce VAP incidence in ICU patients is accumulating. The optimal frequency and concentration for CHX-SOD remains to be demonstrated. From Scannapieco and colleagues’
study we can conclude that twice daily is not necessarily better than once daily, but maybe a four times daily regimen with 2% instead of 0.12% CHX does make a difference.What we need now are well-designed and adequately powered studies to evaluate the effects of these measures on length of ICU stay and survival. If these effects were demonstrated,CHX-SOD would offer a very cheap and (ecologically)safe infection prevention measure in patient populations increasingly suffering from infections caused by AMRB.
口腔护理--预防VAP.pdf
2011-8-14 17:58 上传
点击文件名下载附件
下载积分: 金币 -2 金
43.35 KB, 下载次数: 37, 下载积分: 金币 -2 金
上一篇:院感诊断下一篇:发生鲍氏不动杆菌感染病例的的病人出院后病房的彻底消毒包括哪些内容？
|
|
发表于 2011-8-14 17:55:00
