دورية أكاديمية
أعرض في EDS

Noble element coatings on endotracheal tubes for ventilator-associated pneumonia prevention: A systematic review and meta-analysis of randomized controlled trials in emergency care settings.

التفاصيل البيبلوغرافية
العنوان: Noble element coatings on endotracheal tubes for ventilator-associated pneumonia prevention: A systematic review and meta-analysis of randomized controlled trials in emergency care settings.
المؤلفون: Ashiq N; Department of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar., Munir F; Department of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar., Khan S; Department of Pharmaceutical Sciences, Institute of Chemical Sciences, Government College University, Lahore, Pakistan., Yousaf A; Green Health Pharmaceutical Company, Riyadh, Kingdom of Saudi Arabia., Mahmood MH; Department of Pharmaceutical Sciences, Institute of Chemical Sciences, Government College University, Lahore, Pakistan.; Department of Pharmacology, Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, Pakistan.
المصدر: Medicine [Medicine (Baltimore)] 2024 Sep 20; Vol. 103 (38), pp. e39750.
نوع المنشور: Journal Article; Systematic Review; Meta-Analysis
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 2985248R Publication Model: Print Cited Medium: Internet ISSN: 1536-5964 (Electronic) Linking ISSN: 00257974 NLM ISO Abbreviation: Medicine (Baltimore) Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Hagerstown, Md : Lippincott Williams & Wilkins
مواضيع طبية MeSH: Pneumonia, Ventilator-Associated*/prevention & control , Pneumonia, Ventilator-Associated*/epidemiology , Randomized Controlled Trials as Topic* , Intubation, Intratracheal*/instrumentation , Intubation, Intratracheal*/adverse effects, Humans ; Respiration, Artificial/adverse effects ; Respiration, Artificial/instrumentation ; Length of Stay ; Incidence ; Intensive Care Units
مستخلص: Background: Ventilator-associated pneumonia (VAP) is the second most prevalent nosocomial infection in emergency care settings. An emerging strategy to reduce this risk involves coating endotracheal tubes (ETTs) with noble elements, leveraging the antimicrobial properties of elements such as silver, gold, and palladium. This systematic review and meta-analysis aimed to evaluate the effectiveness of noble element coatings on ETTs in reducing VAP incidence rates, mortality, duration of mechanical ventilation, and length of stay in the intensive care unit (ICU).
Methods: Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a comprehensive search was conducted across 5 databases up to 2024. The quality of the randomized controlled trials was assessed using the updated Cochrane Risk of Bias (RoB) 2 tool. A random-effects meta-analysis was performed using RevMan 5.4 Comprehensive Meta-Analysis software. Statistical heterogeneity among the studies was evaluated using the Higgins I2 value, with P < .05 indicating statistical significance.
Results: Seven randomized controlled trials from 5 countries were identified. Four studies had some concerns regarding bias, 2 had a high RoB, and 1 had a low RoB. Noble metal-coated ETTs resulted in a lower incidence of VAP compared to noncoated ETTs (relative risk, 0.76 [95% confidence interval [CI], 0.60-0.96]). However, there was no significant difference in mortality rates (relative risk, 1.06 [95% CI, 0.93-1.20]), duration of mechanical ventilation (mean difference, -0.10 [95% CI, -1.62 to 1.41]), and ICU stay (mean difference, 0.07 [95% CI, -1.98 to 2.12]).
Conclusion: Noble metal-coated ETTs effectively reduce the incidence of VAP but do not significantly impact mortality rates, the duration of mechanical ventilation, or ICU stay. Therefore, these coated ETTs should be integrated into a holistic care plan addressing all aspects of patient management in emergency care settings.
Competing Interests: The authors have no conflicts of interest to disclose.
(Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)
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تواريخ الأحداث: Date Created: 20240923 Date Completed: 20240923 Latest Revision: 20240926
رمز التحديث: 20240926
مُعرف محوري في PubMed: PMC11419469
DOI: 10.1097/MD.0000000000039750
PMID: 39312345
قاعدة البيانات: MEDLINE
الوصف
تدمد:1536-5964
DOI:10.1097/MD.0000000000039750