Management of Ventilator-Associated Pneumonia Guidelines
Management of Ventilator-Associated Pneumonia Guidelines
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DOI：
10.1016/j.ccm.2018.08.002
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发表时间：
2018-12-01
影响因子：
5.7
通讯作者：
Kalil, Andre C.
中科院分区：
文献类型：
--
作者：
Metersky, Mark L.;Kalil, Andre C.
最近关于呼吸机相关肺炎(VAP)诊断和治疗的两个主要指南建议在制定初始经验性抗生素方案时考虑局部抗生素耐药模式和个体患者耐药病原体的风险。一个建议不要使用定量培养的侵入性诊断技术来确定VAP的原因；另一个建议使用侵入性或非侵入性技术。这两个指南都建议对大多数VAP患者使用短程治疗。虽然这两个指南都没有建议在诊断VAP时使用降钙素原作为临床判断的辅助手段，但它们在使用系列降钙素以缩短抗生素治疗时间方面有所不同。
Two recent major guidelines on diagnosis and treatment of ventilator-associated pneumonia (VAP) recommend consideration of local antibiotic resistance patterns and individual patient risks for resistant pathogens when formulating an initial empiric antibiotic regimen. One recommends against invasive diagnostic techniques with quantitative cultures to determine the cause of VAP; the other recommends either invasive or noninvasive techniques. Both guidelines recommend short course therapy be used for most patients with VAP. Although neither guideline recommends use of procalcitonin as an adjunct to clinical judgment when diagnosing VAP, they differ with respect to use of serial procalcitonin to shorten the length of antibiotic treatment.