Kollef M H, Silver P
Pulmonary and Critical Care Division, Washington University School of Medicine, St Louis, MO 63110, USA.
Respir Care. 1995 Nov;40(11):1130-40.
VAP is a common problem faced by clinicians caring for critically ill patients. Use of appropriate preventive, diagnostic, and therapeutic strategies should minimize morbidity resulting from this clinical problem. Future investigations need to better define the optimum diagnostic methods and the most appropriate use of antibiotics for patients with suspected VAP. Only by developing these strategies can we hope to avoid the complications associated with spiraling empiricism. These complications include numerous outbreaks of serious antibiotic-resistant nosocomial infections due to the empiric over-administration of broad-spectrum antimicrobial agents. Advances in both the clinical and basic medical sciences are likely to help further elucidate the epidemiology and pathogenesis of VAP and, thereby, improve the opportunities for future prevention of this disorder.
呼吸机相关性肺炎（VAP）是重症患者护理临床医生面临的常见问题。采用适当的预防、诊断和治疗策略应能将这一临床问题导致的发病率降至最低。未来的研究需要更好地确定针对疑似VAP患者的最佳诊断方法以及抗生素的最恰当使用方式。只有制定这些策略，我们才有希望避免与经验性治疗不断升级相关的并发症。这些并发症包括因经验性过度使用广谱抗菌药物而引发的众多严重耐药性医院感染暴发。临床和基础医学科学的进展可能有助于进一步阐明VAP的流行病学和发病机制，从而增加未来预防这种疾病的机会。
