Bastin A J, Ryanna K B
Adult Intensive Care Unit, Royal Brompton Hospital, London SW36NP, UK.
Anaesthesia. 2009 Jan;64(1):46-9. doi: 10.1111/j.1365-2044.2008.05676.x.
The use of selective decontamination of the digestive tract (SDD) remains controversial despite several large randomised-controlled trials and meta-analyses. A postal survey of intensive care units in the United Kingdom was conducted to document current use of SDD, and to identify factors influencing this practice. The response rate was 71%. The vast majority (182 units, 95%) do not use SDD mainly because practising clinicians do not believe it works or that there is not enough evidence (51%), and because of concerns about antibiotic resistance (47%). Of the 10 units using SDD, three apply it to all intubated patients and five do not use intravenous antibiotics in their protocol.
尽管有多项大型随机对照试验和荟萃分析,但消化道选择性去污(SDD)的使用仍存在争议。我们对英国的重症监护病房进行了一项邮寄调查,以记录SDD的当前使用情况,并确定影响这种做法的因素。回复率为71%。绝大多数(182个单位,95%)不使用SDD,主要是因为临床医生认为它不起作用或没有足够的证据(51%),以及担心抗生素耐药性(47%)。在使用SDD的10个单位中,有3个将其应用于所有插管患者,5个在其方案中不使用静脉抗生素。