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Báo cáo y học: "Ventilator-associated tracheobronchitis (VAT): questions, answers, and a new paradigm"

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: Ventilator-associated tracheobronchitis (VAT): questions, answers, and a new paradigm? | Available online http ccforum.eom content 12 3 157 Commentary Ventilator-associated tracheobronchitis VAT questions answers and a new paradigm Donald E Craven1 2 1 Department of Infectious Diseases Lahey Clinic Medical Center 41 Mall Road Burlington MA 01805 USA 2Tufts University School of Medicine Boston MA USA Corresponding author Donald E Craven donald.e.craven@lahey.org Published 18 June 2008 This article is online at http ccforum.com content 12 3 157 2008 BioMed Central Ltd Critical Care 2008 12 157 doi 10.1186 cc6912 See related research by Nseir et al. http ccforum.com content 12 3 R62 Abstract Nosocomial lower respiratory tract infections are a common cause of morbidity and mortality in intensive care unit ICU patients. Although many studies have investigated the management and prevention of ventilator-associated pneumonia VAP few have focused on ventilator-associated tracheobronchitis VAT . In this issue of Critical Care Nseir and coworkers present interesting data from a randomized controlled study of antimicrobial therapy for VAT. Patients randomly assigned to antibiotic therapy had more mechanical ventilation-free days P 0.001 fewer episodes of VAP 13 versus 47 P 0.001 and a lower ICU mortality rate 18 versus 47 P 0.05 than those without antibiotic therapy. Although this study has limitations the data suggest that VAT may be an important risk factor for VAP or overlap with early VAP. More importantly targeted antibiotic therapy for VAT may improve patient outcomes and become a new paradigm for prevention or early therapy for VAP. In this issue of Critical Care Nseir and coworkers 1 provide interesting data from a randomized trial of antibiotic therapy for ventilator-associated tracheobronchitis VAT . Although ventilator-associated pneumonia VAP has been the major focus of critical care providers perhaps our focus should also include VAT which may be a precursor to VAP or overlap with early VAP 1-5 . Understanding VAT may have important implications for