دورية أكاديمية
[Less ventilator-associated pneumonia after oral decontamination with chlorhexidine; a randomised trial].
| العنوان: | [Less ventilator-associated pneumonia after oral decontamination with chlorhexidine; a randomised trial]. |
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| عنوان ترانسليتريتد: | Minder beademingspneumonieën door orale decontaminatie met chloorhexidine; gerandomiseerde trial. |
| المؤلفون: | Koeman M; Universitair Medisch Centrum Utrecht, Utrecht. groenendijk-koeman@orange.nl, van der Ven AJ, Hak E, Joore JC, Kaasjager HA, de Smet AM, Ramsay G, Dormans TP, Aarts LP, de Bel EE, Hustinx WN, van der Tweel I, Hoepelman IM, Bonten MJ |
| المصدر: | Nederlands tijdschrift voor geneeskunde [Ned Tijdschr Geneeskd] 2008 Mar 29; Vol. 152 (13), pp. 752-9. |
| نوع المنشور: | English Abstract; Journal Article; Randomized Controlled Trial |
| اللغة: | Dutch; Flemish |
| بيانات الدورية: | Publisher: Vereniging NTvG Country of Publication: Netherlands NLM ID: 0400770 Publication Model: Print Cited Medium: Print ISSN: 0028-2162 (Print) Linking ISSN: 00282162 NLM ISO Abbreviation: Ned Tijdschr Geneeskd Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2017?-: Amsterdam : Vereniging NTvG Original Publication: Houten : Bohn Stafleu van Loghum |
| مواضيع طبية MeSH: | Anti-Infective Agents, Local/*therapeutic use , Chlorhexidine/*therapeutic use , Mouth/*drug effects , Pneumonia, Bacterial/*prevention & control , Ventilators, Mechanical/*adverse effects, Administration, Topical ; Adult ; Anti-Bacterial Agents/administration & dosage ; Anti-Bacterial Agents/therapeutic use ; Anti-Infective Agents, Local/administration & dosage ; Chlorhexidine/administration & dosage ; Colistin/administration & dosage ; Colistin/therapeutic use ; Critical Care ; Double-Blind Method ; Drug Combinations ; Female ; Gram-Negative Bacteria/drug effects ; Gram-Negative Bacteria/isolation & purification ; Gram-Positive Bacteria/drug effects ; Gram-Positive Bacteria/isolation & purification ; Humans ; Length of Stay ; Male ; Middle Aged ; Mouth/microbiology ; Oropharynx/microbiology ; Placebos ; Time Factors ; Trachea/microbiology |
| مستخلص: | Objective: To determine the effect of oral decontamination with either chlorhexidine (CHX, 2%) or the combination chlorhexidine-colistin (CHX-COL, 2%-2%) on the frequency and the time to onset of ventilator-associated pneumonia in Intensive Care patients. Design: Double blind, placebo-controlled, multicentre, randomised trial. Methods: Consecutive ICU patients needing at least 48 h of mechanical ventilation were enrolled in a randomized trial with 3 arms: CHX, CHX-COL, and placebo (PLAC). The trial medication was administered in the oral cavity every 6 h. Oropharyngeal swabs were obtained daily and analysed quantitatively for Gram-positive and Gram-negative microorganisms. Endotracheal colonisation was monitored twice weekly. Ventilator-associated pneumonia was diagnosed on the basis of a combination of clinical, radiological and microbiological criteria. Results: Of 385 patients included, 130 received PLAC, 127 CHX and 128 CHX-COL. Baseline characteristics in the three groups were comparable. The daily risk of ventilator-associated pneumonia was reduced in both treatment groups compared to PLAC: 65% (HR= 0.352; 95% CI: 0.160-0.791; p = 0.012) for CHX and 55% (HR= 0.454; 95%/ CI: 0.224-0.925; p = 0.030) for CHX-COL. CHX-COL provided a significant reduction in oropharyngeal colonisation with both Gram-negative and Gram-positive microorganisms, whereas CHX significantly affected only colonisation with Gram-positive microorganisms. There were no differences in the duration of mechanical ventilation, ICU-stay or ICU-survival. Conclusion: Oral decontamination of the oropharyngeal cavity with chlorhexidine or the combination chlorhexidine-colistin reduced the incidence and the time to onset ofventilator-associated pneumonia. |
| التعليقات: | Comment in: Ned Tijdschr Geneeskd. 2008 Mar 29;152(13):731-3. (PMID: 18461887) |
| المشرفين على المادة: | 0 (Anti-Bacterial Agents) 0 (Anti-Infective Agents, Local) 0 (Drug Combinations) 0 (Placebos) R4KO0DY52L (Chlorhexidine) Z67X93HJG1 (Colistin) |
| تواريخ الأحداث: | Date Created: 20080509 Date Completed: 20080603 Latest Revision: 20151119 |
| رمز التحديث: | 20221213 |
| PMID: | 18461894 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 0028-2162 |
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