Golding David M, Bloomfield Maxim, Davis Joshua, Delaney Anthony, Hills Thomas, Tong Steven Y C, Young Paul J
Intensive Care Unit, Wellington Hospital, Wellington, New Zealand.
Department of Infectious Diseases and Microbiology, Wellington Hospital, Wellington, New Zealand.
Aust Crit Care. 2025 May;38(3):101155. doi: 10.1016/j.aucc.2024.101155. Epub 2025 Jan 20.
Selective decontamination of the digestive tract (SDD) has been investigated as a strategy to reduce the incidence of ventilator-associated pneumonia (VAP) and other healthcare-associated infections in intensive care unit (ICU) patients receiving mechanical ventilation. There is some evidence to suggest that the use of SDD is associated with a reduction in healthcare-associated infection and mortality; however, the uptake of SDD in ICUs in Australia and New Zealand (ANZ) remains low. To better understand the potential reasons, we designed a questionnaire to gather views from specialists in intensive care medicine, infectious diseases, and medical microbiology.
The study incorporated an online survey.
An online survey was distributed to specialists in intensive care medicine, infectious diseases, and medical microbiology working in ANZ.
The main outcome measures are views about SDD and perceived barriers to implementation in ICUs in ANZ.
A total of 103 responses were obtained, of which 55 were from intensive care medicine specialists and the remainder from infectious disease/medical microbiology specialists. No respondents currently used SDD in their hospital ICU. Intensive care medicine specialists self-reported better understanding of the evidence base regarding SDD (P = 0.032) and were more likely to believe that SDD was a safe therapy (P < 0.001) and that it was associated with a reduction in the incidence of VAP (P < 0.001) and ICU mortality (P < 0.001). Infectious disease/medical microbiology specialists were more likely to believe there is currently a lack of evidence of benefit (P < 0.001) and a risk of harm (P < 0.001) associated with SDD.
Specialists in intensive care medicine had more positive views about use of SDD in ventilated patients than did specialists in infectious diseases/medical microbiology, but no respondents reported using SDD in their clinical practice.
消化道选择性去污（SDD）已被作为一种策略进行研究，以降低接受机械通气的重症监护病房（ICU）患者发生呼吸机相关性肺炎（VAP）及其他医疗相关感染的发生率。有证据表明，使用SDD与降低医疗相关感染及死亡率相关；然而，在澳大利亚和新西兰（ANZ）的ICU中，SDD的采用率仍然很低。为了更好地理解潜在原因，我们设计了一份问卷，以收集重症医学、传染病学和医学微生物学专家的意见。
本研究采用在线调查。
向在ANZ工作的重症医学、传染病学和医学微生物学专家发放了一份在线调查问卷。
主要观察指标是关于SDD的意见以及在ANZ的ICU中实施SDD所感知到的障碍。
共获得103份回复，其中55份来自重症医学专家，其余来自传染病/医学微生物学专家。目前没有受访者在其医院的ICU中使用SDD。重症医学专家自我报告对SDD证据基础的理解更好（P = 0.032），并且更有可能认为SDD是一种安全的治疗方法（P < 0.001），并且它与降低VAP发生率（P < 0.001）和ICU死亡率（P < 0.001）相关。传染病/医学微生物学专家更有可能认为目前缺乏与SDD相关的益处证据（P < 0.001）以及存在危害风险（P < 0.001）。
与传染病/医学微生物学专家相比，重症医学专家对在通气患者中使用SDD的看法更为积极，但没有受访者报告在其临床实践中使用SDD。
