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预防捆绑法可降低新生儿呼吸机相关性肺炎的发生率。

Preventive bundle approach decreases the incidence of ventilator-associated pneumonia in newborn infants.

机构信息

Neonatal Research Group, Health Research Institute La Fe, Valencia, Spain.

Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain.

出版信息

J Perinatol. 2021 Jun;41(6):1467-1473. doi: 10.1038/s41372-021-01086-7. Epub 2021 May 25.

Abstract

OBJECTIVE

We hypothesized that the implementation of evidence-based interventions shaping a bundle approach could significantly reduce the incidence of ventilator-associated pneumonia (VAP) in the neonatal intensive care unit.

STUDY DESIGN

We conducted a prospective observational cohort study including neonates undergoing mechanical ventilation >48 h. VAP rate and endotracheal intubation ratio were compared before (pre-period) and after (post-period) applying VAP prevention bundle strategies.

RESULT

One hundred seventy-four neonates were included in pre-period (30 months) and 106 in post-period (17 months). Demographic characteristics were comparable and device use ratios were similar. Twenty-eight VAP episodes were diagnosed, 25 in the first period and 3 after the implementation of prevention bundle. This represents a reduction in the incidence rate from 11.79 to 1.93 episodes/1000 ventilator days (p < 0.01).

CONCLUSION

The implementation of an educational evidence-based program using a bundle approach to prevent VAP has shown a statistically significant reduction in its incidence density.

摘要

目的

我们假设实施以证据为基础的干预措施形成的一整套方案,可以显著降低新生儿重症监护病房(NICU)呼吸机相关性肺炎(VAP)的发生率。

研究设计

我们进行了一项前瞻性观察性队列研究,纳入了机械通气时间超过 48 小时的新生儿。比较了应用 VAP 预防捆绑策略前后(预阶段和后阶段)的 VAP 发生率和气管内插管比例。

结果

174 例新生儿纳入预阶段(30 个月),106 例纳入后阶段(17 个月)。人口统计学特征相似,器械使用比例也相似。诊断出 28 例 VAP 病例,第 1 阶段 25 例,第 1 阶段后 3 例。这表示发病率从每 1000 通气日 11.79 例降至 1.93 例(p<0.01)。

结论

采用捆绑式方法实施基于证据的教育方案预防 VAP 已显示其发病率密度有统计学显著降低。

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