Critical Care:雾化抗生素治疗呼吸机相关性肺炎

2021-08-25 中国呼吸治疗 中国呼吸治疗

雾化抗生素对VAP的临床恢复和微生物根除似乎是一种有用的治疗方法,并且不会增加死亡率或肾毒性风险。

背景

雾化抗生素被认为是治疗呼吸机相关性肺炎(VAP)的一种新的、有希望的治疗方案。然而,VAP的最佳雾化抗生素仍不确定。

方法

我们从两篇系统的回顾和搜索PubMed,EMBASE和Cochrane数据库进行研究。符合条件的研究包括随机对照试验和观察性研究。对提取的数据进行分析。

结果

8项观察研究和8项随机研究被纳入研究。以静脉使用抗生素为参考的配对Meta分析表明,雾化抗生素治疗,患者的临床恢复率(风险比(RR)1.21,95%可信区间(CI)1.09-1.34;P=0.001)和微生物根除率(RR1.42,95%CI1.22-1.650;P<0.0001)显著提高。死亡率(RR0.88,95%CI0.74-1.04;P=0.127)和肾毒性(RR1.00,95%CI0.72-1.39;P=0.995)风险无显著差异。对等级概率的评估中,雾化妥布霉素对临床恢复和降低死亡率有最大的益处,而雾化粘菌素对微生物根除有最大的益处。

结论

雾化抗生素对VAP的临床恢复和微生物根除似乎是一种有用的治疗方法,并且不会增加死亡率或肾毒性风险。

编辑:王淑佳

导师:袁琦伟

审核:RTs

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    2021-08-27 Boyinsh
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    2021-08-26 xzmynya

    很好

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1837980, encodeId=18e0183e9800c, content=<a href='/topic/show?id=3f34e253206' target=_blank style='color:#2F92EE;'>#相关性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72532, encryptionId=3f34e253206, topicName=相关性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=shenxlcyp, createdTime=Mon May 23 15:57:06 CST 2022, time=2022-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1253295, encodeId=1bfe125329564, content=<a href='/topic/show?id=909339652f5' target=_blank style='color:#2F92EE;'>#呼吸机#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39652, encryptionId=909339652f5, topicName=呼吸机)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=726030, createdName=Boyinsh, createdTime=Fri Aug 27 00:57:06 CST 2021, time=2021-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1345262, encodeId=59ff13452626f, content=<a href='/topic/show?id=cd305543152' target=_blank style='color:#2F92EE;'>#抗生素治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55431, encryptionId=cd305543152, topicName=抗生素治疗)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/1103841572/D2FD7704B41C9E22364B1E54ABB223BB/100, createdBy=1df22500220, createdName=ms1260584454294838, createdTime=Fri Aug 27 00:57:06 CST 2021, time=2021-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457761, encodeId=7bf1145e76190, content=<a href='/topic/show?id=e2d1988611e' target=_blank style='color:#2F92EE;'>#雾化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98861, encryptionId=e2d1988611e, topicName=雾化)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b79433, createdName=jiangjun073, createdTime=Fri Aug 27 00:57:06 CST 2021, time=2021-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1011610, encodeId=5d6e1011610b7, content=很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160531/IMG574DA473DF46C6923.jpg, createdBy=e39768313, createdName=xzmynya, createdTime=Thu Aug 26 08:45:50 CST 2021, time=2021-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1011303, encodeId=6ffc101130305, content=很实用, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210825/25feeda2e26248f88951810c40bb87af/985cea2ebc7f46b1bde069164ef7e07a.jpg, createdBy=145a5584307, createdName=张华晟, createdTime=Wed Aug 25 11:35:06 CST 2021, time=2021-08-25, status=1, ipAttribution=)]
    2021-08-25 张华晟

    很实用

    0