Selective decontamination of the digestive tract reduces mortality in critically ill patients.

Selective decontamination of the digestive tract reduces mortality in critically ill patients.
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消化道的选择性净化可降低危重患者的死亡率。

DOI:
10.1186/cc1873
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发表时间:
2003-04
期刊:
影响因子:
15.1
通讯作者:
Kesecioglu, J
Kesecioglu, J
中科院分区:
医学1区
文献类型:
--
作者:
Schultz, MJ;de Jonge, E;Kesecioglu, J

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当面临消化道选择性净化(SDD)时,重症监护医生可能会引发多种情绪反应。尽管最近的荟萃分析表明,SDD 的使用可减少呼吸机相关性肺炎的发生并提高 ICU 生存率,但 SDD 的有效性仍存在争议。我们最近完成了一项关于使用 SDD 的大型随机对照试验,结果显示接受 SDD 治疗的 ICU 患者的生存率有所提高。使用 SDD 的第二个担忧是担心出现抗菌药物耐药性。有趣的是,最近发表的一项研究并没有证实这种担忧,我们最近完成的研究甚至表明,对妥布霉素、头孢他啶、亚胺培南和环丙沙星具有耐药性的铜绿假单胞菌和肠杆菌科细菌的定植有所减少。希望这项研究最终能够结束关于 SDD 对危重患者的疗效和安全性的争论。
Several emotional responses may be invoked in critical care physicians when confronted with selective decontamination of the digestive tract (SDD). Although recent meta-analyses have shown that the use of SDD reduces the occurrence of ventilator-associated pneumonia and improves ICU survival, the effectiveness of SDD has remained controversial. We recently concluded a large randomized, controlled trial on the use of SDD that showed improved survival of ICU patients treated with SDD. A second concern regarding use of SDD has been the fear for the emergence of antimicrobial resistance. Interestingly, a recently published study did not confirm this fear, and our recently finished study even demonstrated a decline in colonization with P. aeruginosa and enterobacteriaceae that were resistant against tobramycin, ceftazidime, imipenem and ciprofloxacin. The hopes are that this study will at long last end the debate about the efficacy and safety of SDD in critically ill patients.
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