[原创翻译]ICU中严重酗酒患者比那些轻度或中度饮酒者更容易发生获得性的细菌感染
[align=center]ICU中严重酗酒患者比那些轻度或中度饮酒者更容易发生获得性的细菌感染翻译：鸭绿江 gala [/align]
摘要：
目的：检验那些在ICU中过度饮酒的非创伤患者是否更容易发生获得性的细菌感染，特别是呼吸机相关性肺炎(VAP)。
研究设计：前瞻性的观察队列研究。
研究场所：一家大学医院里拥有21张床位的多价ICU
病例选择：在一年内收住ICU、留住时间至少3天并且能够评估饮酒量的358例成年患者。
干预措施：无
方法和结果：根据国家研究院颁布的酗酒和酒精中毒标准，本研究有1/3的患者（358例中的111例患者）为严重酗酒者，其中有61例患者每天饮酒至少5次，有73例患者的简化Michigan酒精减少试验评分>=3分。有88例患者被诊断为ICU获得性细菌感染，69例患者至少有一次VAPs，严重酗酒组中有40例（36%）发生获得性的细菌感染，非严重酗酒组中有48例（19%）发生获得性的细菌感染，两者相比p < .001，在严重酗酒组中，每天饮酒5次以上的患者比那些每天饮酒少于5次的患者，更容易发生细菌感染(p = .048)，比较了年龄、性别、简化急性生理学评分II、进入ICU前的住院时间、进入ICU前24小时的抗生素给药、入院类型、免疫抑制、机械通气时间、以及留置中心静脉导管和导尿管情况，发现严重酗酒者在任何时候都和获得性的细菌感染（危险比1.92，95%置信区1.17-3.14; p = .009)以及呼吸机相关性肺炎（危险比1.76，95%置信区1.05-3.06; p = .04)显著关联。
结论：严重酗酒是ICU获得性细菌感染的一个显著的风险因子。
[color=Red]本人水平有限，翻译错误之处在所难免，还望各位老师指正，谢谢！[/color]
原文译自：
Critical Care Medicine. 36(6):1735-1741, June 2008.
原文：
[quote]At-risk drinkers are at higher risk to acquire a bacterial infection during an intensive care unit stay than abstinent or moderate drinkers *.
Clinical Investigations
Critical Care Medicine. 36(6):1735-1741, June 2008.
Gacouin, Arnaud MD; Legay, Francois MD; Camus, Christophe MD; Volatron, Anne-Claire MD; Barbarot, Nicolas MD; Donnio, Pierre-Yves PhD; Thomas, Remi MD; Le Tulzo, Yves MD
Abstract:
Objectives: To determine whether excessive alcohol consumption increases the risk for intensive care unit (ICU)-acquired bacterial infection, especially ventilator-associated pneumonia (VAP), in nontrauma patients.
Design: Prospective observational cohort study.
Setting: A 21-bed polyvalent ICU in a university hospital.
Patients: A total of 358 adult patients admitted over a 1-yr period who had an ICU stay >=3 days and in whom alcohol consumption could be assessed.
Interventions: None.
Measurements and Mean Results: Thirty-one percent of the patients (111 of 358) were identified as at-risk drinkers according to the National Institute on Alcohol Abuse and Alcoholism criteria. Among these, 61 had a daily intake of five or more drinks per day and 73 had Simplified Michigan Alcohol Short Test scores >=3. ICU-acquired bacterial infections were diagnosed in 88 patients, and 69 patients had one or more VAPs. Forty (36%) at-risk drinkers acquired bacterial infections vs. 48 (19%) not-at-risk drinkers (p < .001). Among at-risk drinkers, the proportion of patients who developed bacterial infection was higher in at-risk drinkers consuming five or more drinks per day compared with at-risk drinkers consuming fewer than five drinks per day (p = .048). After adjustment for age, gender, Simplified Acute Physiology Score II, length of hospital stay before ICU admission, prior antibiotic administration within 24 hrs before ICU admission, type of admission, immunosuppression, duration of mechanical ventilation, and central venous and urinary catheter exposure, at-risk drinking remained significantly associated with the acquisition of bacterial infection at any site (hazard ratio 1.92; 95% confidence interval, 1.17-3.14; p = .009) and of VAP (hazard ratio 1.76; 95% confidence interval, 1.05-3.06; p = .04).
Conclusions: At-risk drinking was a significant risk factor for acquisition of ICU-acquired bacterial infection.[/quote]
[[i] 本帖最后由 gala 于 2008-8-13 13:08 编辑 [/i]]
页:
[1]
