Systematic Review on the Importance of Preventive Measures for Pneumonia Associated with Mechanical Ventilation
Coelho Jf, Coelho As, Filho Ijz
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引用次数: 0
Abstract
Introduction: Ventilator-associated pneumonia (VAP) occurs in 9.0% to 27.0% of patients on mechanical ventilation (MV) and has a global mortality rate of 13.0%. VAP is the most frequent infection acquired in the intensive care unit (ICU) among patients submitted to this ventilatory support, resulting in mortality rates’ ranging from 20.0% to 70.0%, with the use of antibiotics is presented in the literature as the most effective prophylactic measure. Objective: The primary objective of this study was to review national and international scientific literature on preventive measures and pneumonia associated with mechanical ventilation. The secondary objective was to discuss the efficacy of preventive measures for ventilator-associated pneumonia. Methods: After literary search criteria with the use of Mesh terms: pneumonia, antibiotics, prophylactic antibiotics, mechanical ventilation, patients at risk, major care, contamination and clinical trials and use of the bouleanos “and” between mesh terms and “or” among the historical findings. In the main databases such as Pubmed, Medline, Bireme, EBSCO, Scielo, etc., a total of 56 papers that were submitted to the eligibility analysis were cross-checked and after that 21 studies were selected, following the rules of systematic review-PRISMA. Results: The results suggest that the use of intravenous and technological support that the surgical patient needs on the day of ICU admission is a risk factor for the development of VAP, as well as the prior use of antibiotics. In addition, the results confirm that VAP significantly increases the mechanical ventilation time and the time of ICU injection. Conclusion: EPI is an important cause of increased morbidity and mortality in severe ICU patients. Enteral nutrition was an important risk factor and previous use of antibiotic protection factor for the development of VAP. Studies to determine incidence and risk factors are useful in guiding the implementation of measures to improve diagnostic accuracy and to implement preventive measures. *Corresponding author: Idiberto José Zotarelli Filho, Unipos Post Graduate and Continuing Education, Street Ipiranga, 3460, São José do Rio Preto SP, Brazil, Tel: +55(17) 98166-6537; E-mail: m.zotarelli@gmail.com Received December 20, 2018; Accepted January 20, 2019; Published January 31, 2019 Citation: Coelho JF, Coelho AS, Filho IJZ (2019) Systematic Review on the Importance of Preventive Measures for Pneumonia Associated with Mechanical Ventilation. J Pulm Respir Med 9: 483. doi: 10.4172/2161-105X.1000483 Copyright: © 2019 Coelho JF, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
机械通气相关肺炎预防措施重要性的系统综述
导论:呼吸机相关性肺炎(VAP)在机械通气(MV)患者中的发生率为9.0%至27.0%,全球死亡率为13.0%。VAP是重症监护病房(ICU)患者中最常见的感染,死亡率为20.0% ~ 70.0%,文献中认为使用抗生素是最有效的预防措施。目的:本研究的主要目的是回顾与机械通气相关的预防措施和肺炎的国内和国际科学文献。次要目的是探讨呼吸机相关性肺炎预防措施的有效性。方法:根据文献检索标准,使用Mesh术语:肺炎、抗生素、预防性抗生素、机械通气、高危患者、主要护理、污染和临床试验,以及使用“bouleanos”和“Mesh术语之间”和“或”的历史发现。在Pubmed、Medline、Bireme、EBSCO、Scielo等主要数据库中,按照系统评价- prisma的规则,对56篇投稿论文进行交叉核对,筛选出21篇研究。结果:结果提示手术患者在ICU入院当天的静脉和技术支持使用情况以及既往使用抗生素是VAP发生的危险因素。此外,结果证实VAP明显增加机械通气时间和ICU注射时间。结论:EPI是重症ICU患者发病率和死亡率增高的重要原因。肠内营养是VAP发生的重要危险因素,既往使用抗生素保护因子是VAP发生的重要危险因素。确定发病率和危险因素的研究有助于指导实施提高诊断准确性和实施预防措施的措施。*通讯作者:Idiberto jos Zotarelli Filho, Unipos研究生和继续教育,Street Ipiranga, 3460, s o jos do里约热内卢Preto SP,巴西,电话:+55(17)98166-6537;邮箱:m.zotarelli@gmail.com 2018年12月20日收稿;2019年1月20日录用;引用本文:Coelho JF, Coelho AS, Filho IJZ(2019)关于机械通气相关肺炎预防措施重要性的系统综述。[J]中华肺科杂志9:483。2161 - 105 - x.1000483 doi: 10.4172 /版权所有:©2019 Coelho JF, et al。这是一篇根据知识共享署名许可协议发布的开放获取文章,该协议允许在任何媒体上不受限制地使用、分发和复制,前提是要注明原作者和来源。
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