Clinician views on selective decontamination of the digestive tract in mechanically ventilated patients in intensive care units: A survey.

IF 2.6 3区 医学 Q2 CRITICAL CARE MEDICINE Australian Critical Care Pub Date : 2025-01-20 DOI:10.1016/j.aucc.2024.101155
David M Golding, Maxim Bloomfield, Joshua Davis, Anthony Delaney, Thomas Hills, Steven Y C Tong, Paul J Young
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Abstract

Objective: Selective decontamination of the digestive tract (SDD) has been investigated as a strategy to reduce the incidence of ventilator-associated pneumonia (VAP) and other healthcare-associated infections in intensive care unit (ICU) patients receiving mechanical ventilation. There is some evidence to suggest that the use of SDD is associated with a reduction in healthcare-associated infection and mortality; however, the uptake of SDD in ICUs in Australia and New Zealand (ANZ) remains low. To better understand the potential reasons, we designed a questionnaire to gather views from specialists in intensive care medicine, infectious diseases, and medical microbiology.

Design: The study incorporated an online survey.

Setting and participants: An online survey was distributed to specialists in intensive care medicine, infectious diseases, and medical microbiology working in ANZ.

Main outcome measures: The main outcome measures are views about SDD and perceived barriers to implementation in ICUs in ANZ.

Results: A total of 103 responses were obtained, of which 55 were from intensive care medicine specialists and the remainder from infectious disease/medical microbiology specialists. No respondents currently used SDD in their hospital ICU. Intensive care medicine specialists self-reported better understanding of the evidence base regarding SDD (P = 0.032) and were more likely to believe that SDD was a safe therapy (P < 0.001) and that it was associated with a reduction in the incidence of VAP (P < 0.001) and ICU mortality (P < 0.001). Infectious disease/medical microbiology specialists were more likely to believe there is currently a lack of evidence of benefit (P < 0.001) and a risk of harm (P < 0.001) associated with SDD.

Conclusions: Specialists in intensive care medicine had more positive views about use of SDD in ventilated patients than did specialists in infectious diseases/medical microbiology, but no respondents reported using SDD in their clinical practice.

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临床医生对重症监护室机械通气患者选择性消化道去污的看法:一项调查。
目的:探讨选择性消化道去污(SDD)作为降低重症监护病房(ICU)机械通气患者呼吸机相关性肺炎(VAP)和其他医疗相关感染发生率的策略。有一些证据表明,使用SDD与降低卫生保健相关感染和死亡率有关;然而,在澳大利亚和新西兰(ANZ)的icu中,SDD的使用率仍然很低。为了更好地了解潜在的原因,我们设计了一份问卷,收集重症监护医学、传染病和医学微生物学专家的意见。设计:该研究结合了在线调查。环境和参与者:一份在线调查被分发给在澳新银行工作的重症监护医学、传染病和医学微生物学专家。主要结果测量:主要结果测量是关于SDD的观点和在澳新银行icu中实施的感知障碍。结果:共获得103份回复,其中重症医学专科55份,传染病/医学微生物学专科55份。没有受访者目前在其医院ICU使用SDD。重症监护医学专家自我报告对SDD的证据基础有更好的理解(P = 0.032),并且更有可能相信SDD是一种安全的治疗方法(P结论:重症监护医学专家对通气患者使用SDD的看法比传染病/医学微生物学专家更积极,但没有受访者报告在临床实践中使用SDD。
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来源期刊
Australian Critical Care
Australian Critical Care NURSING-NURSING
CiteScore
4.90
自引率
9.10%
发文量
148
审稿时长
>12 weeks
期刊介绍: Australian Critical Care is the official journal of the Australian College of Critical Care Nurses (ACCCN). It is a bi-monthly peer-reviewed journal, providing clinically relevant research, reviews and articles of interest to the critical care community. Australian Critical Care publishes peer-reviewed scholarly papers that report research findings, research-based reviews, discussion papers and commentaries which are of interest to an international readership of critical care practitioners, educators, administrators and researchers. Interprofessional articles are welcomed.
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