Selective decontamination of the digestive tract and ventilator-associated pneumonia (part 1).

نویسندگان

  • Luciano Silvestri
  • Andy J Petros
  • Marino Viviani
  • Johannes H Rommes
  • Hendrik K F van Saene
چکیده

resistance in esophageal resection. Intensive Care Med 1990;16 Suppl 3:S224–228. 28. van der Voort PH, van Roon EN, Kampinga GA, Boerma EC, Gerritsen RT, Egbers PH, Kuiper MA. A before-after study of multiresistance and cost of selective decontamination of the digestive tract. Infection 2004; 32(5):271–277. 29. Diez-Roux AV. Bringing context back into epidemiology: variables and fallacies in multilevel analysis. Am J Public Health 1998;88(2):216–222. 30. Gastinne H, Wolff M, Delatour F, Faurisson F, Chevret S. A controlled trial in intensive care units of selective decontamination of the digestive tract with nonabsorbable antibiotics. The French Study Group on Selective Decontamination of the Digestive Tract. N Engl J Med 1992; 326(9):594–599. 31. Kollef MH. Opinion: the clinical use of selective digestive decontamination. Crit Care 2000;4(6):327–332. 32. Monnet DL, MacKenzie FM, LopezLozano JM, Beyaert A, Camacho M, Wilson R, et al. Antimicrobial drug use and methicillin-resistant Staphylococcus aureus, Aberdeen, 1996–2000. Emerg Infect Dis 2004;10(8):1432–1441. 33. Morgenstern H. Ecologic studies. In: Rothman KJ, Greenland S, editors. Modern epidemiology. Philadelphia: LippincottRaven; 1998:459–480. 34. Klein BS, Perloff WH, Maki DG. Reduction of nosocomial infection during pediatric intensive care by protective isolation. N Engl J Med 1989;320(26):1714–1721. 35. Johnson S, Gerding DN, Olson MM, Weiler MD, Hughes RA, Clabots CR, Peterson LR. Prospective, controlled study of vinyl glove use to interrupt Clostridium difficile nosocomial transmission. Am J Med 1990;88(2): 137–140. 36. Maki DG, Zilz MA, McCormick R. The effectiveness of using preemptive barrier precautions routinely (protective isolation) in all high-risk patients to prevent nosocomial infection with resistant organisms, especially MRSA, VRE, and C. difficile (abstract). Proceedings and abstracts of the Thirty-fourth Annual Meeting of the Infectious Disease Society of America, New Orleans, Louisiana, September 1996. Clin Infect Dis 1996;23:43. 37. Montecalvo MA, Jarvis WR, Uman J, Shay DK, Petrullo C, Rodney K, et al. Infectioncontrol measures reduce transmission of vancomycin-resistant enterococci in an endemic setting. Ann Intern Med 1999;131(4): 269–272. 38. Srinivasan A, Song X, Ross T, Merz W, Brower R, Perl TM. A prospective study to determine whether cover gowns in addition to gloves decrease nosocomial transmission of vancomycin-resistant enterococci in an intensive care unit. Infect Control Hosp Epidemiol 2002;23(8):424–428. 39. Safdar N, Marx J, Meyer N, Maki DG. The effectiveness of preemptive enhanced barrier precautions for controlling MRSA in a burn unit (abstract). Proceedings and abstracts of the 43rd InterScience Conference on Antimicrobial Agents and Chemotherapy, 2003; Chicago, Illinois. 40. Paterson DL, Singh N, Rihs JD, Squier C, Rihs BL, Muder RR. Control of an outbreak of infection due to extended-spectrum beta-lactamase–producing Escherichia coli in a liver transplantation unit. Clin Infect Dis 2001;33(1):126–128. 41. Bonten MJ, Hayden MK, Nathan C, van Voorhis J, Matushek M, Slaughter S, et al. Epidemiology of colonisation of patients and environment with vancomycin-resistant enterococci. Lancet 1996;348(9042):1615– 1619. 42. Bonten MJ, Slaughter S, Ambergen AW, Hayden MK, van Voorhis J, Nathan C, Weinstein RA. The role of “colonization pressure” in the spread of vancomycin-resistant enterococci: an important infection control variable. Arch Intern Med 1998; 158(10):1127–1132. 43. Maki DG. Nosocomial infection in the intensive care unit. In: Parrillo J, Bone R, editors. Critical care medicine. St Louis: Mosby; 1994:893–954. 44. Drakulovic MB, Torres A, Bauer TT, Nicolas JM, Nogue S, Ferrer M. Supine body position as a risk factor for nosocomial pneumonia in mechanically ventilated patients: a randomised trial. Lancet 1999; 354(9193):1851–1858. 45. Valles J, Artigas A, Rello J, Bonsoms N, Fontanals D, Blanch L, et al. Continuous aspiration of subglottic secretions in preventing ventilator-associated pneumonia. Ann Intern Med 1995;122(3):179–186.

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Review: several interventions prevent ventilator associated pneumonia in critically ill patients.

Conclusions Semirecumbent positioning, stress ulcer prophylaxis (sucralfate rather than H2 antagonists), aspiration of subglottic secretions, selective digestive tract decontamination, and oscillating beds reduce ventilator associated pneumonia (VAP) in select critically ill patients. No evidence currently supports specific methods of enteral feeding or increased frequency of ventilator circuit...

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Selective decontamination of the digestive tract.

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Prevention of ventilator-associated pneumonia by selective decontamination of the digestive tract.

We read with interest the review entitled ‘‘Evidence on measures for the prevention of ventilator-associated pneumonia’’ by LORENTE et al. [1]. We enjoyed the paper as it is comprehensive and based on an appropriate design. In particular, we welcome the authors’ acknowledgement of the proven clinical benefits of selective decontamination of the digestive tract (SDD). The authors give four expla...

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Selective digestive decontamination is superior to selective oropharyngeal decontamination

are interested in the debate on the effi cacy and safety of selective digestive decontamination (SDD) and selective oropharyngeal decontamination (SOD) raised by Schultz and Haas in their review [1]. Th e authors concluded that 'SDD and SOD are equally eff ective with respect to the prevention of mortality' [1]. Th is statement is based on the results of a Dutch randomized controlled trial [2],...

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Should selective digestive decontamination be used in critically ill patients?

Healthcare associated infection represents a major burden for critically ill patients; a recent point prevalence survey by the Health Protection Agency observed that 23.4% of patients in intensive care units had evidence of a healthcare associated infection.Ventilator associated pneumonia remains the leading cause of nosocomial infection in this population, and, although recent estimates of att...

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عنوان ژورنال:
  • Respiratory care

دوره 51 1  شماره 

صفحات  -

تاریخ انتشار 2006