Silvestri L, van Saene H K F
Department of Emergency, Unit of Anesthesia and Intensive Care, Presidio Ospedaliero di Gorizia, Gorizia, Italy.
HSR Proc Intensive Care Cardiovasc Anesth. 2012;4(1):21-9.
Selective decontamination of the digestive tract has been proven to prevent severe infections and to reduce mortality in critically ill patients. Historical arguments against its use, like the development of bacterial resistance and the absence of influence on mortality, have not been confirmed. Recent clinical trials designed to evaluate these variables and meta-analyses showed remarkable reductions in the incidence of resistant bacteria and a significant beneficial effect on survival. This review will update the evidence on the efficacy of selective decontamination of the digestive tract, and the issue of emergence of resistance, using data from randomized controlled trials and meta-analyses.
已证实胃肠道选择性去污可预防重症患者发生严重感染并降低死亡率。以往反对使用该方法的理由，如细菌耐药性的产生以及对死亡率无影响等，并未得到证实。近期旨在评估这些变量的临床试验和荟萃分析表明，耐药菌的发生率显著降低，且对生存率有显著的有益影响。本综述将利用随机对照试验和荟萃分析的数据，更新关于胃肠道选择性去污疗效及耐药性出现问题的证据。
