selective decontamination of the digestive tract reduces pneumonia and mortality的选择性净化消化道减少肺炎和死亡.pdfVIP

Hindawi Publishing Corporation Critical Care Research and Practice Volume 2010, Article ID 501031, 11 pages doi:10.1155/2010/501031 Review Article Selective Decontamination of the Digestive Tract Reduces Pneumonia and Mortality Lenneke E. M. Haas1 and Marcus J. Schultz1, 2 1 Department of Intensive Care Medicine, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands 2 Laboratory of Experimental Intensive Care and Anesthesiology (L.E.I.C.A), Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands Correspondence should be addressed to Lenneke E. M. Haas, lennekehaas@ Received 29 July 2010; Accepted 20 September 2010 Academic Editor: J. L. Vincent Copyright © 2010 L. E. M. Haas and M. J. Schultz. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Selective decontamination of the digestive tract (SDD) has been subject of numerous randomized controlled trials in critically ill patients. Almost all clinical trials showed SDD to prevent pneumonia. Nevertheless, SDD has remained a controversial strategy. One reason for why clinicians remained reluctant to implement SDD into daily practice could be that mortality was reduced in only 2 trials. Another reason could be the heterogeneity of trials of SDD. Indeed, many different prophylactic antimicrobial regimes were tested, and dissimilar diagnostic criteria for pneumonia were applied amongst the trials. This heterogeneity impeded interpretation and comparison of trial results. Two other hampering factors for implementation of SDD have been concerns o