Critical Care Medicine:规范ICU患者动脉置管,预防相关感染

2015-08-23 MedSci MedSci原创

根据美国罗得岛医院研究人员进行的一项调查,不同的医生在为ICU患者行动脉置管的方式有明显差异,一些做法可能会增加导管相关性感染风险。不到一半的受访者的做法符合当前CDC动脉导管感染预防指南。这项研究发表于Critical Care Medicine。罗得岛医院流行病学和感染控制科主任医师Leonard A. Mermel认为,大家遵循不同的标准和指南,导致医生固定动脉导管时的方式不一致,这会导致医

根据美国罗得岛医院研究人员进行的一项调查,不同的医生在为ICU患者行动脉置管的方式有明显差异,一些做法可能会增加导管相关性感染风险。研究表明:不到一半的受访者的做法符合当前CDC动脉导管感染预防指南。这项研究发表于Critical Care Medicine。


罗得岛医院流行病学和感染控制科主任医师Leonard A. Mermel认为,大家遵循不同的标准和指南,导致医生固定动脉导管时的方式不一致,这会导致医生低估动脉导管相关性感染对患者的风险。为了降低病人的住院时长和感染几率,为他们节约不必要的开支,医生应该采取一切措施避免动脉导管相关性感染的出现。

2011年CDC颁布相关使用指南,建议临床医生戴无菌手套、手术帽和口罩,且在动脉导管插入病人动脉前铺好无菌巾。在1265名医生中,只有44%的参与者在动脉导管插入时使用CDC预防指南,仅有15%的参与者全程遵循CDC的预防指南。 

Andrew Levinson博士认为,临床对有动脉置管的ICU病人采取的预防措施与CDC的预防指南差异很大。血液感染大多可以预防,如果这项研究真的反映现状,则说明在预防ICU病人感染方面还有很多需要努力。

研究人员进行了匿名调查,调查参与者包括ICU医生(特别是主治医生)、实验员、居民、护士、实习医生、注册护士、全科护士和呼吸治疗师。研究表明,所有的医院都完全符合CDC的预防指南。研究的医院包括罗得岛医及其儿童分院、孩之宝儿童医院、米里亚姆医院、新港医院。
动脉导管是ICU常用的用来监测病人血压和血气等的工具,每年美国大约要使用8百万个动脉置管。但是由于动脉导管经由皮肤进入病人动脉,因此很容易出现血液感染导致败血症等的出现。

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    2016-04-28 kalseyzl
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