selective decontamination of the digestive tract reduces mortality in critically ill patients选择性净化消化道降低危重患者的死亡率.pdfVIP

Available online /content/7/2/107 Commentary Selective decontamination of the digestive tract reduces mortality in critically ill patients 1 1 2 Marcus J Schultz , Evert de Jonge and Jozef Kesecioglu 1Internist-Intensivist, Department of Intensive Care Medicine, Academic Medical Center, University of Amsterdam, The Netherlands 2Anaesthesiologist-Intensivist, Division of Perioperative Care, Cardiopulmonary Intensive Care and Neuro Intensive Care, University Medical Center, Utrecht, The Netherlands Correspondence: Marc J Schultz, m.j.schultz@amc.uva.nl Published online: 24 January 2003 Critical Care 2003, 7:107-110 (DOI 10.1186/cc1873) This article is online at /content/7/2/107 © 2003 BioMed Central Ltd (Print ISSN 1364-8535; Online ISSN 1466-609X) Abstract Several emotional responses may be invoked in critical care physicians when confronted with selective decontamination of the digestive tract (SDD). Although recent meta-analyses have shown that the use of SDD reduces the occurrence of ventilator-associated pneumonia and improves ICU survival, the effectiveness of SDD has remained controversial. We recently concluded a large randomized, controlled trial on the use of SDD that showed improved survival of ICU patients treated with SDD. A second concern regarding use of SDD has been the fear for the emergence of antimicrobial resistance. Interestingly, a recently published study did not confirm this fear, and our recently finished study even demonstrated a decline in colonization with P. aer