{"id":27789,"date":"2025-04-18T04:31:00","date_gmt":"2025-04-17T20:31:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=27789"},"modified":"2025-04-18T05:39:51","modified_gmt":"2025-04-17T21:39:51","slug":"chest%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%8e%a5%e5%8f%97%e6%9c%89%e5%88%9b%e6%9c%ba%e6%a2%b0%e9%80%9a%e6%b0%94%e7%9a%84%e6%88%90%e5%b9%b4%e6%80%a5%e6%80%a7%e8%84%91%e6%8d%9f%e4%bc%a4","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=27789","title":{"rendered":"[Chest\u53d1\u8868\u8bba\u6587]\uff1a\u63a5\u53d7\u6709\u521b\u673a\u68b0\u901a\u6c14\u7684\u6210\u5e74\u6025\u6027\u8111\u635f\u4f24\u60a3\u8005\u7684\u9884\u9632\u6027\u6297\u751f\u7d20"},"content":{"rendered":"\n

Critical Care: Original Research<\/p>\n\n\n\n

Prophylactic Antibiotics in Adults With Acute Brain Injury Who Are Invasively Ventilated in the ICU: A Systematic Review and Meta-Analysis<\/h1>\n\n\n\n

Kathryn\u00a0Hadley-Brown,\u00a0Laura\u00a0Hailstone,\u00a0Roisin\u00a0Devane, et al<\/h3>\n\n\n\n

Chest Available online 28 October 2024<\/h3>\n\n\n\n

https:\/\/doi.org\/10.1016\/j.chest.2024.10.031<\/h3>\n\n\n\n

Background<\/h3>\n\n\n\n

Lower respiratory tract infections are common in patients receiving invasive mechanical ventilation in an ICU after an acute brain injury and may have deleterious consequences.<\/p>\n\n\n\n

Research Question<\/h3>\n\n\n\n

In adults with acute brain injury receiving invasive mechanical ventilation in an ICU, is the administration of prophylactic parenteral antibiotics, compared with placebo or usual care, associated with reduced mortality?<\/p>\n\n\n\n

Study Design and Methods<\/h3>\n\n\n\n

We conducted a systematic review and meta-analysis. We searched for randomized clinical trials (RCTs) in electronic databases, as well as unpublished trials. The primary outcome was hospital mortality, and secondary outcomes included the incidence of ventilator-associated pneumonia, ICU length of stay, and duration of mechanical ventilation. We used a random effects model to estimate the pooled risk ratio (RR) with corresponding 95% CI for binary outcomes and the mean difference (MD) with 95% CI for continuous outcomes. Certainty of evidence was evaluated using Grading of Recommendations Assessment Development and Evaluation methods.<\/p>\n\n\n\n

Results<\/h3>\n\n\n\n

One thousand seven hundred twenty-eight reports of studies were screened, with 7 RCTs recruiting 835 participants included. No trials were adjudicated as having a high risk of bias. The pooled estimated RR for mortality associated with the use of prophylactic antibiotics was 0.91 (95%\u00a0CI, 0.70-1.17;\u00a0P<\/em>\u00a0= .39; low certainty). The pooled estimated RR for ventilator-associated pneumonia was 0.56 (95%\u00a0CI, 0.35-0.89; low certainty). The pooled estimated duration of mechanical ventilation for those allocated to prophylactic antibiotics compared with control participants (MD, \u20132.0\u00a0days; 95%\u00a0CI, \u20136.1 to 2.1\u00a0days; very low certainty) and duration of ICU admission (MD, \u20132.2\u00a0days; 95%\u00a0CI, \u20135.4 to 1.1\u00a0days; very low certainty) were similar.<\/p>\n\n\n\n

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Interpretation<\/h3>\n\n\n\n

Current evidence from randomized clinical trials does not provide definitive evidence regarding the effect of prophylactic antibiotics on mortality in patients receiving invasive mechanical ventilation in the ICU.<\/p>\n\n\n\n

Clinical Trial Registry<\/h3>\n\n\n\n

International Prospective Register of Systematic Reviews; No.: CRD42023424732; URL: https:\/\/www.crd.york.ac.uk\/prospero\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Critical Care: Original Research Prophylactic Antibioti […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/27789"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=27789"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/27789\/revisions"}],"predecessor-version":[{"id":27790,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/27789\/revisions\/27790"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=27789"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=27789"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=27789"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}