کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5671608 1408062 2017 27 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Key considerations on nebulization of antimicrobial agents to mechanically ventilated patients
ترجمه فارسی عنوان
ملاحظات کلیدی در انفجار عوامل ضد میکروبی به بیماران تهویه مکانیکی
کلمات کلیدی
آمینوگلیکوزید، ضدعفونی کننده آنتی بیوتیک، کولیستین، ارگانیسم های مقاوم در برابر چندین رژیم، نبولایزرها، پنومونی مرتبط با ونتیلاتور، تراکئو برونشیت مرتبط با ونتیلاتور،
موضوعات مرتبط
علوم زیستی و بیوفناوری ایمنی شناسی و میکروب شناسی میکروب شناسی
چکیده انگلیسی
Nebulized antibiotics have an established role in patients with cystic fibrosis or bronchiectasis. Their potential benefit to treat respiratory infections in mechanically ventilated patients is receiving increasing interest. In this consensus statement of the European Society of Clinical Microbiology and Infectious Diseases, the body of evidence of the therapeutic utility of aerosolized antibiotics in mechanically ventilated patients was reviewed and resulted in the following recommendations: Vibrating-mesh nebulizers should be preferred to jet or ultrasonic nebulizers. To decrease turbulence and limit circuit and tracheobronchial deposition, we recommend: (a) the use of specifically designed respiratory circuits avoiding sharp angles and characterized by smooth inner surfaces, (b) the use of specific ventilator settings during nebulization including use of a volume controlled mode using constant inspiratory flow, tidal volume 8 mL/kg, respiratory frequency 12 to 15 bpm, inspiratory:expiratory ratio 50%, inspiratory pause 20% and positive end-expiratory pressure 5 to 10 cm H2O and (c) the administration of a short-acting sedative agent if coordination between the patient and the ventilator is not obtained, to avoid patient's flow triggering and episodes of peak decelerating inspiratory flow. A filter should be inserted on the expiratory limb to protect the ventilator flow device and changed between each nebulization to avoid expiratory flow obstruction. A heat and moisture exchanger and/or conventional heated humidifier should be stopped during the nebulization period to avoid a massive loss of aerosolized particles through trapping and condensation. If these technical requirements are not followed, there is a high risk of treatment failure and adverse events in mechanically ventilated patients receiving nebulized antibiotics for pneumonia.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Clinical Microbiology and Infection - Volume 23, Issue 9, September 2017, Pages 640-646
نویسندگان
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