期刊
CRITICAL CARE
卷 20, 期 -, 页码 -出版社
BIOMED CENTRAL LTD
DOI: 10.1186/s13054-016-1472-5
关键词
Ventilator-associated respiratory infection (VARI); Ventilator-associated tracheobronchitis (VAT); Ventilator-associated pneumonia (VAP); Bacterial pathogen virulence; Antibiotic sensitivity; Use of early appropriate antibiotic therapy; VAP prevention; Patient outcomes; Morbidity; Mortality and healthcare costs
Mechanically ventilated, intubated patients are at increased risk for tracheal colonization with bacterial pathogens that may progress to heavy bacterial colonization, ventilator-associated tracheobronchitis (VAT), and/or ventilator-associated pneumonia (VAP). Previous studies report that 10 to 30 % of patients with VAT progress to VAP, resulting in increased morbidity and significant acute and chronic healthcare costs. Several natural history studies, randomized, controlled trials, and a meta-analysis have reported antibiotic treatment for VAT can reduce VAP, ventilator days, length of intensive care unit (ICU) stay, and patient morbidity and mortality. We discuss early diagnostic criteria, etiologic agents, and benefits of initiating, early, appropriate intravenous or aerosolized antibiotic(s) to treat VAT and reduce VAP, to improve patient outcomes by reducing lung damage, length of ICU stay, and healthcare costs.
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