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首页> 外文期刊>Infection control and hospital epidemiology >Periodically changing ventilator circuits is not necessary to prevent ventilator-associated pneumonia when a heat and moisture exchanger is used.
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Periodically changing ventilator circuits is not necessary to prevent ventilator-associated pneumonia when a heat and moisture exchanger is used.

机译：使用热湿交换器时，不必定期更换呼吸机回路以防止呼吸机相关性肺炎。

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摘要

OBJECTIVE: To analyze the efficacy of periodically changing ventilator circuits for decreasing the rate of ventilator-associated pneumonia when a heat and moisture exchanger (HME) is used for humidification. The Centers for Disease Control and Prevention recommended not changing the circuits periodically. DESIGN: Randomized, controlled trial conducted between April 2001 and August 2002. SETTING: A 24-bed, medical-surgical intensive care unit in a 650-bed, tertiary-care hospital. PATIENTS: All patients requiring mechanical ventilation during more than 72 hours from April 2001 to August 2002. INTERVENTIONS: Patients were randomized into two groups: (1) ventilation with change of ventilator circuits every 48 hours and (2) ventilation with no change of circuits. Throat swabs were taken on admission and twice weekly until discharge to classify pneumonia as endogenous or exogenous. RESULTS: Three hundred four patients (143 from group 1 and 161 from group 2) with similar characteristics (age, gender, Acute Physiology and Chronic Health Evaluation II score, diagnostic group, and mortality) were analyzed. There was no significant difference in the rate of pneumonia between the groups (23.1% vs 23.0% and 15.5 vs 14.8 per 1,000 ventilator-days). There was no significant difference in the incidence of exogenous pneumonia per 1,000 days of mechanical ventilation (1.71 vs 1.25). There was no difference in the distribution of microorganisms causing pneumonia. CONCLUSIONS: Circuit change using an HME for humidification does not decrease pneumonia and represents an unnecessary cost.
机译：目的：分析当使用湿热交换器（HME）进行加湿时，定期更换呼吸机回路以降低呼吸机相关性肺炎的效率。疾病控制与预防中心建议不要定期更换电路。设计：2001年4月至2002年8月间进行的随机对照试验。地点：一家拥有650张床的三级护理医院的24张床的医疗外科重症监护室。患者：从2001年4月至2002年8月，所有需要机械通气的患者均在72小时以上。 。入院时取咽拭子，每周两次，直到出院将肺炎归为内源性或外源性。结果：分析了具有相似特征（年龄，性别，急性生理学和慢性健康评估II评分，诊断组和死亡率）的340例患者（第1组为143例，第2组为161例）。两组之间的肺炎发生率无显着差异（每千名呼吸机天数分别为23.1％对23.0％和15.5对14.8对1）。每1,000天的机械通气中外源性肺炎的发生率没有显着差异（1.71对1.25）。引起肺炎的微生物分布没有差异。结论：使用HME进行加湿的电路更换不会减少肺炎，并且代表了不必要的成本。

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