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ICM：多模式策略预防中心静脉导管相关血行感染

2018-03-01 杨中华 脑血管病及重症文献导读

多模式策略中心静脉导管血行感染预防
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2018年1月来自荷兰的Tjallie van der Kooi等在Intensive Care Med上公布了PROHIBIT试验结果，目的在于验乞中心静脉导管（central venous catheter, CVC）植入策略和手卫生改进策略预防CVC相关血行感染（central venous catheter-related bloodstream infections, CRBSI）的作用


2018年1月来自荷兰的Tjallie van der Kooi等在Intensive Care Med上公布了PROHIBIT试验结果，目的在于验乞中心静脉导管（central venous catheter, CVC）植入策略和手卫生改进策略预防CVC相关血行感染（central venous catheter-related bloodstream infections, CRBSI）的作用。

PROHIBIT为阶梯簇随机对照多中心干预性研究，由来自11个欧洲国家共14家医院的成人ICU参与。经过6个月收集基线资料后，根据设定的随机方案这些医院分别执行以下三种干预措施：1.CVC植入培训策略（CVCi）（译者注：具体方案参考http://www.carepractice.net/）；2.手卫生改进策略（HHi）（译者注：具体方案参考http://www.who.int/gpsc/5may/tools/en/）；3.CVCi联合HHi策略（COMBi）。主要终点为CRBSI发病密度。

该研究共纳入25348例患者，共35831次CVC。CRBSI发病密度从基线2.4/1000/CVC-天降低到0.9/1000/CVC-天（P < 0.0001）。当校正患者和CVC特征后，所有三项干预措施都能显著降低CRBSI发病密度。当校正基线降低趋势后，HHi和COMBi仍然有效。所有三项干预措施的CVC植入计分和手卫生依从性都显著提高。

最终作者认为多模式预防策略（CVC植入练习和手卫生的改进措施）能够降低CRBSI，依从性提高和CRBSI下降有关。

原始出处：

Prevention of hospital infections by intervention and training (PROHIBIT): results of a pan-European cluster-randomized multicentre study to reduce central venous catheter-related bloodstream infections.Intensive Care Med. 2018 Jan;44(1):48-60. doi: 10.1007/s00134-017-5007-6. Epub 2017 Dec 16.

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    2018-10-07 guojianrong

    #中心静脉#

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    2018-04-25 柳叶一刀

    #静脉#

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    2018-03-03 lancelotzzl

    #中心静脉导管#

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    2018-03-02 changjiu

    学习一下谢谢

    0

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    2018-03-01 131****1460

    学习了受益匪浅

    0