Strategies for preventing ventilator-associated pneumonia in adults in the Middle East and North Africa Region: A systematic review and meta-analysis.

IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Annals of Thoracic Medicine Pub Date : 2025-04-01 Epub Date: 2025-02-24 DOI:10.4103/atm.atm_237_24
Omar Abousaad, Aisha Al-Ajji, Noor Abouazab, Adel Aljoaid, Jithin K Sreedharan
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引用次数: 0

Abstract

Background: Ventilator-associated pneumonia (VAP) is a common complication in intensive care units (ICUs), particularly in patients undergoing prolonged mechanical ventilation. VAP rates vary significantly across regions, with the Middle East and North Africa (MENA) region experiencing relatively high incidences. This study systematically reviews and analyses the efficacy of various VAP prevention strategies in the adult population of the MENA region.

Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. Electronic databases (PubMed, Scopus, and CINAHL) were searched for studies from January 2004 to May 2024 that investigated VAP prevention strategies in adult ICU patients in the MENA region. Data extraction and quality assessment were performed by multiple independent reviewers. Meta-analysis was carried out using the DerSimonian and Laird random effect models.

Results: A total of 10 randomized clinical trials conducted in Iran and Tunisia were included. The studies evaluated various interventions, including respiratory care programs, oral care protocols, and tracheal suction techniques. Significant reductions in VAP incidence were observed with interventions such as aerosolized colistin and comprehensive oral care (e.g., clove mouthwash). However, certain interventions, such as ondansetron and N-acetylcysteine, did not yield significant benefits.

Conclusion: This meta-analysis highlights effective VAP prevention strategies in the MENA region, with notable improvements in patient outcomes. These findings can potentially help in developing policies and guidelines to enhance VAP prevention efforts across ICUs in the region. Further research is essential to address existing gaps and refine prevention strategies.

中东和北非地区成人呼吸机相关肺炎预防策略:系统综述和荟萃分析
背景:呼吸机相关性肺炎(VAP)是重症监护病房(icu)常见的并发症,特别是在长时间机械通气的患者中。不同地区的VAP发病率差异很大,中东和北非地区的发病率相对较高。本研究系统地回顾和分析了各种VAP预防策略在中东和北非地区成年人中的效果。方法:根据PRISMA指南进行系统评价和荟萃分析。检索电子数据库(PubMed、Scopus和CINAHL),检索2004年1月至2024年5月在中东和北非地区调查成人ICU患者VAP预防策略的研究。数据提取和质量评估由多位独立审稿人完成。meta分析采用DerSimonian和Laird随机效应模型。结果:共纳入在伊朗和突尼斯进行的10项随机临床试验。这些研究评估了各种干预措施,包括呼吸护理方案、口腔护理方案和气管吸引技术。通过雾化粘菌素和综合口腔护理(如丁香漱口水)等干预措施,观察到VAP发生率显著降低。然而,某些干预措施,如昂丹司琼和n -乙酰半胱氨酸,并没有产生显著的益处。结论:该荟萃分析强调了中东和北非地区有效的VAP预防策略,显著改善了患者的预后。这些发现可能有助于制定政策和指导方针,以加强该地区icu的VAP预防工作。进一步的研究对于解决现有差距和完善预防战略至关重要。
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来源期刊
Annals of Thoracic Medicine
Annals of Thoracic Medicine CARDIAC & CARDIOVASCULAR SYSTEMS-RESPIRATORY SYSTEM
CiteScore
4.10
自引率
4.30%
发文量
19
审稿时长
>12 weeks
期刊介绍: The journal will cover studies related to multidisciplinary specialties of chest medicine, such as adult and pediatrics pulmonology, thoracic surgery, critical care medicine, respiratory care, transplantation, sleep medicine, related basic medical sciences, and more. The journal also features basic science, special reports, case reports, board review , and more. Editorials and communications to the editor that explore controversial issues and encourage further discussion by physicians dealing with chest medicine.
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