EBM - How to Reduce Symptoms of Ventilator-Associated Tracheobronchitis Infections?

Long-term use of mechanical ventilation may increase the risk of ventilator-associated tracheobronchitis (VAT). Intravenous antibiotics are commonly used to treat VAT clinically; moreover, inhaled antibiotics may be used to treat this infection. Inhalaed antibiotics can directly reach infected parts through the trachea. Thus, the effectiveness of VAT treatment is improved and the risk of more adverse conditions such as ventilator-associated pneumonia(VAP) is reduced. Furthermore, the use of inhalaed antibiotics can shorten the duration of mechanical ventilation use and the length of stay in an intensive care unit. To understand the effectiveness of inhalable and injectable antibiotics, this study adopted the five steps of evidence-based practice. We found a previous systematic review to be the optimal evidence-based reference, and we thus examined it closely in this study. The results indicated that inhalaed antibiotics can alleviate the symptoms of VAT, reduce the amount of sputum secreted, and reduce the frequency of intravenous antibiotics use. In the future, we will verify the experimental results by using inhalable antibiotics in an intensive care unit and demonstrating their treatment effectiveness.

關鍵字

EBM ； Tracheobronchitis Infections ； Ventilator-Associated Tracheobronchitis ； inhaled antibiotics

並列摘要

呼吸器長期使用可能會增加病人罹患呼吸器相關氣管支氣管炎（Ventilator-Associated Tracheobronchitis；VAT）的機率，臨床上常以靜脈注射型抗生素治療，但也可使用吸入型抗生素治療。使用吸入型抗生素可能可以讓藥物經由氣管直達感染部位，達到更佳治療效益，進而減少進一步發展成呼吸器相關肺炎（Ventilator-Associated Pneumonia；VAP）的機會；因此，也可降低病人使用呼吸器及加護病房停留時間。為了解吸入型與注射型抗生素在呼吸器相關氣管支氣管炎的治療效益，本文運用「實證醫學五步驟」方式，搜尋到一篇系統性回顧文獻為最佳實證文獻並予以仔細評讀。結果顯示，吸入型抗生素可降低呼吸器相關氣管支氣管炎的感染症狀，減少痰液量分泌並降低使用注射型抗生素的比率。未來，吾人將依此實證結果，運用吸入型抗生素於某地區醫院加護病房的病人，驗證其治療成效。

並列關鍵字