TAILIEUCHUNG - Báo cáo y học: "Diagnostic techniques for ventilator-associated pneumonia: Conflicting results from two trials"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Diagnostic techniques for ventilator-associated pneumonia: Conflicting results from two trials. | Available online at http content 13 3 303 University of Pittsburgh Department of Critical Care Medicine Evidence-Based Medicine Journal Club EBM Journal Club Section Editor Eric B. Milbrandt MD MPH Journal club critique Diagnostic techniques for ventilator-associated pneumonia Conflicting results from two trials Younghoon Kwon 1 Eric B. Milbrandt2 and Sachin Yende2 1 Clinical Fellow Department of Critical Care Medicine University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA 2 Assistant Professor Department of Critical Care Medicine University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA Published online 14th May 2009 This article is online at http content 13 3 303 2009 BioMed Central Ltd Critical Care 2009 13 303 DOI cc7797 Expanded Abstract Citation A randomized trial of diagnostic techniques for ventilator-associated pneumonia. N Engl J Med 2006 355 2619-2630 1 . Background Critically ill patients who require mechanical ventilation are at risk for ventilator-associated pneumonia. Current data are conflicting as to the optimal diagnostic approach in patients who have suspected ventilator-associated pneumonia. Methods Objective To compare the quantitative culture of bronchoalveolar-lavage fluid and nonquantitative culture of endotracheal aspirate in critically ill patients with suspected ventilator-associated pneumonia testing the hypothesis that bronchoscopy with quantitative culture would be associated with lower mortality rates and less use of antibiotics. Design Multi-center non-blinded randomized controlled trial. Setting 28 intensive care units ICUs across Canada and the United States. Subjects 740 immunocompetent critically ill adult patients with suspected ventilator-associated pneumonia after 4 days in the ICU. Patients known to be colonized or infected with Pseudomonas species or methicillin-resistant Staphylococcus aureus were excluded. Intervention Using a 2-by-2 factorial design subjects .

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