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气管插管相关性肺炎:一项综合综述。

Intubation-associated pneumonia: An integrative review.

作者信息

Sousa Ana Sabrina, Ferrito Cândida, Paiva José Artur

机构信息

Hospital de S.João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal; Universidade Católica Portuguesa, Rua Arquiteto Lobão Vital, Apartado 2511, 4202-401 Porto, Portugal; Escola Superior de Enfermagem do Porto, Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal.

Instituto Politécnico de Setúbal-Escola Superior de Saúde, Campus do Instituto Politécnico Setúbal, Edificio da ESCE, Estefanilha, 2914 Setúbal, Portugal.

出版信息

Intensive Crit Care Nurs. 2018 Feb;44:45-52. doi: 10.1016/j.iccn.2017.08.003. Epub 2017 Aug 30.

Abstract

OBJECTIVE

This article aims to characterise intubation-associated pneumonia regarding its diagnosis, causes, risk factors, consequences and incidence.

RESEARCH METHODOLOGY

Integrative literature review using database Pubmed and B-on and webpages of organisations dedicated to this area of study.

SETTING

The research took place between May and July 2015. After selection of the articles, according to established criteria, their quality was assessed and 17 documents were included.

RESULTS

Evidence has demonstrated that intubation associated pneumonia has a multifactorial aetiology and one of its main causes is micro-aspiration of gastric and oropharynx contents. Risk factors can be internal or external. The diagnostic criteria are based on clinical, radiological and microbiological data, established by several organisations, including the European Centres for Disease Control and Prevention, which are, however, still not accurate. In recent years, there has been a downward trend in the incidence in Europe. Nevertheless, it continues to have significant economic impact, as well as affecting health and human lives.

CONCLUSIONS

Several European countries are committed to addressing this phenomenon through infection control and microbial resistance programmes; however there is a much to be done in order to minimise its effects. The lack of consensus in the literature regarding diagnosis criteria, risk factors and incidence rates is a limitation of this study.

摘要

目的

本文旨在对气管插管相关性肺炎的诊断、病因、危险因素、后果及发病率进行描述。

研究方法

通过使用数据库PubMed和B-on以及致力于该研究领域的组织的网页进行综合文献综述。

背景

研究于2015年5月至7月进行。根据既定标准对文章进行筛选后,评估其质量并纳入了17篇文献。

结果

有证据表明,气管插管相关性肺炎具有多因素病因,其主要病因之一是胃内容物和口咽内容物的微量误吸。危险因素可分为内在因素和外在因素。诊断标准基于临床、放射学和微生物学数据,由包括欧洲疾病预防控制中心在内的多个组织制定,然而这些标准仍不够准确。近年来,欧洲的发病率呈下降趋势。尽管如此,它仍然具有重大的经济影响,同时也影响健康和人类生命。

结论

几个欧洲国家致力于通过感染控制和微生物耐药性计划来应对这一现象;然而,为了尽量减少其影响,仍有许多工作要做。文献中关于诊断标准、危险因素和发病率缺乏共识是本研究的一个局限性。

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