Selective decontamination of subglottic area in mechanically ventilated patients with multiple trauma
Φόρτωση...
Ημερομηνία
Συγγραφείς
Pneumatikos, I.
Koulouras, V.
Nathanail, C.
Goe, D.
Nakos, G.
Τίτλος Εφημερίδας
Περιοδικό ISSN
Τίτλος τόμου
Εκδότης
Περίληψη
Τύπος
Είδος δημοσίευσης σε συνέδριο
Είδος περιοδικού
peer-reviewed
Είδος εκπαιδευτικού υλικού
Όνομα συνεδρίου
Όνομα περιοδικού
Intensive Care Med
Όνομα βιβλίου
Σειρά βιβλίου
Έκδοση βιβλίου
Συμπληρωματικός/δευτερεύων τίτλος
Περιγραφή
OBJECTIVE: To determine whether selective decontamination locally in the subglottic area (SDSA) reduces tracheal colonization and prevents ventilator-associated pneumonia (VAP) in patients with multiple trauma. DESIGN AND SETTING: A prospective randomized, controlled, clinical study in a 14-bed general intensive care unit of a university hospital. PATIENTS: 79 consecutive multiple trauma patients admitted to the ICU who were expected to be mechanically ventilated for more than 5 days; 61 patients completed the protocol. INTERVENTION: Patients were randomly assigned to receive SDSA using a continuous infusion of a suspension containing three nonabsorbable antibiotics (polymyxin, tombramycin, and amphotericin B; n=30) or placebo ( n=31). MEASUREMENTS: The incidence of bronchial and gastric colonization and the number of cases of VAP were recorded. Gastric fluid and tracheal secretion cultures were obtained soon after intubation and thereafter every 4 days. Etiological diagnosis of VAP was based on samples taken by a specific protected double catheter set. RESULTS: VAP developed in 5 of 30 (16.6%) patients receiving SDSA and 16 of 31 (51.6%) patients receiving placebo. Negative bronchial secretion cultures were found in 14 of 30 (46.6%) patients in the SDSA group and in only 3 of 31 (9.6%) patients in the control group. No patient with negative bronchial secretion culture developed VAP. No significant differences in outcome were found. CONCLUSIONS: The SDSA is an effective and safe type of chemoprophylaxis against tracheal colonization and can significantly reduce the incidence of VAP in mechanically ventilated patients with multiple trauma.
Περιγραφή
Λέξεις-κλειδιά
Adult, Antibiotic Prophylaxis/*methods, Bacterial Infections/prevention & control, Chi-Square Distribution, Cross Infection/prevention & control, Female, Humans, Male, Multiple Trauma/*therapy, Pneumonia, Bacterial/etiology/*prevention & control, Prospective Studies, Respiration, Artificial/*adverse effects, Trachea/microbiology
Θεματική κατηγορία
Παραπομπή
Σύνδεσμος
http://www.ncbi.nlm.nih.gov/pubmed/11967597
http://www.springerlink.com/content/pf9rwty1wt4j0nyk/fulltext.pdf
http://www.springerlink.com/content/pf9rwty1wt4j0nyk/fulltext.pdf
Γλώσσα
en
Εκδίδον τμήμα/τομέας
Όνομα επιβλέποντος
Εξεταστική επιτροπή
Γενική Περιγραφή / Σχόλια
Ίδρυμα και Σχολή/Τμήμα του υποβάλλοντος
Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής