基于循证医学的VAP预防控制实践指南

David

J Crit Care. 2008 Mar;23(1):126-137. Links
Comprehensive evidence-based clinical practice guidelines for ventilator-associated pneumonia: Prevention.
基于循证医学的VAP预防控制实践指南
Muscedere J, Dodek P, Keenan S, Fowler R, Cook D, Heyland D; for the VAP Guidelines Committee and the Canadian Critical Care Trials Group.
Department of Medicine, Queen's University, Kingston, Canada K7L 2V7.

BACKGROUND: Ventilator-associated pneumonia (VAP) is an important cause of morbidity and mortality in ventilated critically ill patients. PURPOSE: To develop evidence-based guidelines for the prevention of VAP. DATA SOURCES: MEDLINE, EMBASE, CINAHL, and the Cochrane Database of Systematic Reviews and Register of Controlled Trials. STUDY SELECTION: The authors systematically searched for all relevant randomized, controlled trials and systematic reviews on the topic of prevention of VAP in adults that were published from 1980 to October 1, 2006. DATA EXTRACTION: Independently and in duplicate, the panel scored the internal validity of each trial. Effect size, confidence intervals, and homogeneity of the results were scored using predefined definitions. Scores for the safety, feasibility, and economic issues were assigned based on consensus of the guideline panel. LEVELS OF EVIDENCE: The following statements were used: recommend, consider, do not recommend, and no recommendation due to insufficient or conflicting evidence. DATA SYNTHESIS: To prevent VAP: CONCLUSION: There are a growing number of evidence-based strategies for VAP prevention, which, if applied in practice, may reduce the incidence of this serious nosocomial infection.

麦苗

译:
背景：VAP是引起上呼吸机的重症病人发病和死亡的一个重要因素。
目的：建立基于循证医学的VAP预防指南。
数据来源：MEDLINE, EMBASE, CINAHL, Cochrane
研究筛选：发表在1980年到2006年10月1日，与预防成人VAP有关的随机对照研究和系统综述。
资料提取：专家组独立对每个研究进行两组评价，用预先设定的标准评价内在效度，样本含量，可信区间，结果的同质性。评价安全性，可行性，和指南专家组共同议定的经济问题。证据级别：按下列顺序：推荐，考试，不推荐，由于证据不充分或矛盾不推荐。
资料综合：用于预防VAP
结论：循证VAP预防策略逐渐增加，如果将其用于实践可以减少这类严重医源性感染的发生。

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