Dept of Pulmonology, Hospital Clínic de Barcelona, Universitat de Barcelona and IDIBAPS, CIBERES, Barcelona, Spain
These two authors contributed equally to this work.
Eur Respir J. 2017 Sep 10;50(3). doi: 10.1183/13993003.00582-2017. Print 2017 Sep.
The most recent European guidelines and task force reports on hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) were published almost 10 years ago. Since then, further randomised clinical trials of HAP and VAP have been conducted and new information has become available. Studies of epidemiology, diagnosis, empiric treatment, response to treatment, new antibiotics or new forms of antibiotic administration and disease prevention have changed old paradigms. In addition, important differences between approaches in Europe and the USA have become apparent.The European Respiratory Society launched a project to develop new international guidelines for HAP and VAP. Other European societies, including the European Society of Intensive Care Medicine and the European Society of Clinical Microbiology and Infectious Diseases, were invited to participate and appointed their representatives. The Latin American Thoracic Association was also invited.A total of 15 experts and two methodologists made up the panel. Three experts from the USA were also invited (Michael S. Niederman, Marin Kollef and Richard Wunderink).Applying the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) methodology, the panel selected seven PICO (population-intervention-comparison-outcome) questions that generated a series of recommendations for HAP/VAP diagnosis, treatment and prevention.
最近的欧洲关于医院获得性肺炎(HAP)和呼吸机相关性肺炎(VAP)的指南和专家组报告是在近 10 年前发布的。此后,又进行了进一步的 HAP 和 VAP 随机临床试验,并且有了新的信息。关于流行病学、诊断、经验性治疗、治疗反应、新抗生素或新形式的抗生素给药以及疾病预防的研究改变了旧的模式。此外,欧洲和美国之间的方法学也存在明显差异。欧洲呼吸学会启动了制定新的 HAP 和 VAP 国际指南的项目。其他欧洲学会,包括欧洲重症监护医学学会和欧洲临床微生物学和传染病学会,也被邀请参与并任命了他们的代表。拉丁美洲胸科协会也被邀请参加。共有 15 名专家和两名方法学家组成了专家组。还邀请了来自美国的三位专家(Michael S. Niederman、Marin Kollef 和 Richard Wunderink)。专家组采用 GRADE(推荐分级、评估、制定与评价)方法,选择了七个 PICO(人群-干预-比较-结局)问题,这些问题产生了一系列关于 HAP/VAP 诊断、治疗和预防的建议。