tailieunhanh - Báo cáo y học: " Death by acid rain: VAP or EXIT"

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: Death by acid rain: VAP or EXIT? | Available online http content 13 6 1008 Commentary Death by acid rain VAP or EXIT Kentigern Thorburn1 2 and Andrew Darbyshire1 1 Department of Paediatric Intensive Care Royal Liverpool Children s Hospital - Alder Hey Liverpool L12 2AP UK 2School of Host Defence and Infection The University of Liverpool Liverpool L69 7ZX UK Corresponding author Kentigern Thorburn Published 2 December 2009 Critical Care 2009 13 1008 doi cc8169 This article is online at http content 13 6 1008 2009 BioMed Central Ltd See related research by Abdel Gawad et al. http content 13 5 R164 Abstract Ventilator-associated pneumonia VAP is a new nosocomial lower respiratory tract infection diagnosed in mechanically ventilated patients 48 or more hours after intubation. There is no gold standard for establishing the diagnosis and its pathogenesis is iatrogenic and multifactorial. Gastro-oesophageal reflux is common in mechanically ventilated children but its role in VAP remains speculative. VAP is associated with increased mortality and morbidity prolonged duration of ventilation and hospital stay and escalated costs of hospitalisation. VAP bundles are championed as the antidote. Ventilator-associated pneumonia VAP is defined as a new nosocomial lower respiratory tract infection diagnosed in mechanically ventilated patients 48 hours early-onset VAP or 4 days late-onset VAP after intubation 1-5 . Management of early-onset and late-onset VAP may differ as the causative factors and likely pathogens will influence treatment strategies such as antimicrobial therapy 2 3 5 . VAP is associated with increased mortality and morbidity prolonged duration of ventilation and hospital stay and escalated costs of hospitalisation 2 3 5-9 . In resource-rich countries VAP is reported to be the second most common nosocomial hospital-acquired infection in pediatric and neonatal intensive care units with incidences ranging from 3 to 30 and .