Paradoxical ventilator associated pneumonia incidences among selective digestive decontamination studies versus other studies of mechanically ventilated patients: Benchmarking the evidence base

Critical Care

Volumn 15, Issue 1, 2011, Pages

  Hurley, James C ^a,b  

^a UNIVERSITY OF MELBOURNE   (Australia)

^b ST JOHN OF GOD HOSPITAL   (Australia)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; ASSISTED VENTILATION; HUMAN; INFECTION PREVENTION; INJURY; INTERMETHOD COMPARISON; INTERVENTION STUDY; OBSERVATIONAL STUDY; PREDICTOR VARIABLE; PRIORITY JOURNAL; QUALITY CONTROL; VENTILATED PATIENT; VENTILATOR ASSOCIATED PNEUMONIA; ARTIFICIAL VENTILATION; DIGESTIVE SYSTEM; EVIDENCE BASED MEDICINE; INCIDENCE; META ANALYSIS; METHODOLOGY; MICROBIOLOGY; REVIEW; WASTE MANAGEMENT;

BENCHMARKING; DECONTAMINATION; DIGESTIVE SYSTEM; EVIDENCE-BASED MEDICINE; HUMANS; INCIDENCE; PNEUMONIA, VENTILATOR-ASSOCIATED; RESPIRATION, ARTIFICIAL;

EID: 78650947507     PISSN: 13648535     EISSN: 1466609X     Source Type: Journal    
DOI: 10.1186/cc9406     Document Type: Article

References (143)

1. George DL. Epidemiology of nosocomial ventilator-associated pneumonia. Infect Control Hosp Epidemiol 1993, 14:163-169. 10.1086/646705, 8478532.
2. Cook DJ, Kollef MH. Risk factors for ICU-acquired pneumonia. JAMA 1998, 279:1605-1606. 10.1001/jama.279.20.1605, 9613899.
3. Chastre J, Fagon JY. Ventilator-associated pneumonia. Am J Respir Crit Care Med 2002, 165:867-903.
4. Bergmans DCJJ, Bonten MJM. Nosocomial pneumonia. Hospital Epidemiology and Infection Control 2004, 311-339. Philadelphia: Lippincott Williams & Wilkins, Mayhall CG, 3.
5. Safdar N, Dezfulian C, Collard HR, Saint S. Clinical and economic consequences of ventilator-associated pneumonia: a systematic review. Crit Care Med 2005, 33:2184-2193. 10.1097/01.CCM.0000181731.53912.D9, 16215368.
6. Liberati A, D'Amico R, Pifferi S, Torri V, Brazzi L, Parmelli E. Antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving intensive care (Review). Cochrane Database Syst Rev 2009, CD000022.
7. Messori A, Trippoli S, Vaiani M, Gorini M, Corrado A. Bleeding and pneumonia in intensive care patients given ranitidine and sucralfate for prevention of stress ulcer: meta-analysis of randomised controlled trials. BMJ 2000, 321:1103-1106. 10.1136/bmj.321.7269.1103, 27516, 11061729.
8. Subirana M, Solà I, Benito S. Closed tracheal suction systems versus open tracheal suction systems for mechanically ventilated adult patients. Cochrane Database Syst Rev 2007, CD004581.
9. Siempos II, Vardakas KZ, Kopterides P, Falagas ME. Impact of passive humidification on clinical outcomes of mechanically ventilated patients: a meta-analysis of randomized controlled trials. Crit Care Med 2007, 35:2843-2851. 10.1097/01.CCM.0000295302.67973.9A, 18074484.
10. Stoutenbeek CP, van Saene HK, Miranda DR, Zandstra DF. The effect of selective decontamination of the digestive tract on colonisation and infection rate in multiple trauma patients. Intensive Care Med 1984, 10:185-192. 10.1007/BF00259435, 6470306.
11. de Smet AMGA, Kluytmans JAJW, Cooper BS, Mascini EM, Benus RFJ, van der Werf TS, van der Hoeven JG, Pickkers P, Bogaers-Hofman D, van der Meer NJ, Bernards AT, Kuijper EJ, Joore JC, Leverstein-van Hall MA, Bindels AJ, Jansz AR, Wesselink RM, de Jongh BM, Dennesen PJ, van Asselt GJ, te Velde LF, Frenay IH, Kaasjager K, Bosch FH, van Iterson M, Thijsen SF, Kluge GH, Pauw W, de Vries JW, Kaan JA, et al. Decontamination of the digestive tract and oropharynx in ICU patients. NEJM 2009, 360:20-31. 10.1056/NEJMoa0800394, 19118302.
12. Hurley JC. Profound effect of study design factors on ventilator-associated pneumonia incidence of prevention studies: benchmarking the literature experience. J Antimicrob Chemother 2008, 61:1154-1161. 10.1093/jac/dkn086, 18326854.
13. Higgins JP, Thompson SG, Spiegelhalter DJ. A re-evaluation of random-effects meta-analysis. J R Stat Soc Ser A Stat Soc 2009, 172:137-159. 10.1111/j.1467-985X.2008.00552.x, 2667312, 19381330.
14. Spiegelhalter DJ. Handling over-dispersion of performance indicators. Qual Saf Health Care 2005, 14:347-351. 10.1136/qshc.2005.013755, 1744077, 16195568.
15. Agresti A. Categorical Data Analysis 2002, Hoboken: Wiley Interscience, 2.
16. Greenland S, O'Rourke K. Meta-analysis. Modern Epidemiology 2008, 652-682. Philadelphia: Lippincott, Williams and Wilkins, Rothman KJ, Greenland S, Lash TL, 3.
17. Harris RJ, Bradburn MJ, Deeks JJ, Harbord RM, Altmamn DG, Sterne JA. Metan: fixed and random effects-meta-analysis. Stata J 2008, 8:3-28.
18. Harbord RM, Higgins JP. Meta-regression in Stata. Stata J 2008, 8:493-519.
19. Akca O, Koltka K, Uzel S, Cakar N, Pembeci K, Sayan MA, Tutuncu AS, Karakas SE, Calangu S, Ozkan T, Esen F, Telci L, Sessler DI, Akpir K. Risk factors for early-onset, ventilator-associated pneumonia in critical care patients: selected multiresistant versus nonresistant bacteria. Anesthesiology 2000, 93:638-645. 10.1097/00000542-200009000-00011, 10969295.
20. Apostolopoulou E, Bakakos P, Katostaras T, Gregorakos L. Incidence and risk factors for ventilator-associated pneumonia in 4 multidisciplinary intensive care units in Athens, Greece. Respir Care 2003, 48:681-688.
21. Baker AM, Meredith JW, Haponik EF. Pneumonia in intubated trauma patients. Microbiology and outcomes. Am J Respir Crit Care Med 1996, 153:343-349.
22. Baraibar J, Correa H, Mariscal D, Gallego M, Valles J, Rello J. Risk factors for infection by Acinetobacter baumannii in intubated patients with nosocomial pneumonia. Chest 1997, 112:1050-1054. 10.1378/chest.112.4.1050, 9377916.
23. Beck-Sague CM, Sinkowitz RL, Chinn RY, Vargo J, Kaler W, Jarvis WR. Risk factors for ventilator-associated pneumonia in surgical intensive-care-unit patients. Infect Control Hosp Epidemiol 1996, 17:374-376. 10.1086/647323, 8805072.
24. Bercault N, Boulain T. Mortality rate attributable to ventilator-associated nosocomial pneumonia in an adult intensive care unit: a prospective case-control study. Crit Care Med 2001, 29:2303-2309. 10.1097/00003246-200112000-00012, 11801831.
25. Bochicchio GV, Joshi M, Bochicchio K, Shih D, Meyer W, Scalea TM. A time-dependent analysis of intensive care unit pneumonia in trauma patients. J Trauma 2004, 56:296-301. 10.1097/01.TA.0000109857.22312.DF, 14960971.
26. Bonten MJ, Gaillard CA, van Tiel FH, Smeets HG, van der Geest S, Stobberingh EE. The stomach is not a source for colonization of the upper respiratory tract and pneumonia in ICU patients. Chest 1994, 105:878-884. 10.1378/chest.105.3.878, 8131556.
27. Braun SR, Levin AB, Clark KL. Role of corticosteroids in the development of pneumonia in mechanically ventilated head-trauma victims. Crit Care Med 1986, 14:198-201. 10.1097/00003246-198603000-00006, 3943336.
28. Craven DE, Kunches LM, Kilinsky V, Lichtenberg DA, Make BJ, McCabe WR. Risk factors for pneumonia and fatality in patients receiving continuous mechanical ventilation. Am Rev Respir Dis 1986, 133:792-796.
29. Daschner F, Kappstein I, Schuster F, Scholz R, Bauer E, Joossens D, Just H. Influence of disposable ('Conchapak') and reusable humidifying systems on the incidence of ventilation pneumonia. J Hosp Infect 1988, 11:161-168. 10.1016/0195-6701(88)90059-X, 2896685.
30. Daumal F, Colpart E, Manoury B, Mariani M, Daumal M. Changing heat and moisture exchangers every 48 hours does not increase the incidence of nosocomial pneumonia. Infect Control Hosp Epidemiol 1999, 20:347-349. 10.1086/501631, 10349954.
31. de Latorre FJ, Pont T, Ferrer A, Rossello J, Palomar M, Planas M. Pattern of tracheal colonization during mechanical ventilation. Am J Respir Crit Care Med 1995, 152:1028-1033.
32. Eggimann P, Hugonnet S, Sax H, Touveneau S, Chevrolet JC, Pittet D. Ventilator-associated pneumonia: caveats for benchmarking. Intensive Care Med 2003, 29:2086-2089. 10.1007/s00134-003-1991-9, 12955177.
33. Elatrous S, Boukef R, Ouanes Besbes L, Marghli S, Nooman S, Nouira S, Abroug F. Diagnosis of ventilator-associated pneumonia: agreement between quantitative cultures of endotracheal aspiration and plugged telescoping catheter. Intensive Care Med 2004, 30:853-858. 10.1007/s00134-004-2270-0, 15052387.
34. Fagon JY, Chastre J, Domart Y, Trouillet JL, Pierre J, Darne C, Gibert C. Nosocomial pneumonia in patients receiving continuous mechanical ventilation. Prospective analysis of 52 episodes with use of a protected specimen brush and quantitative culture techniques. Am Rev Respir Dis 1989, 139:877-884.
35. Fagon JY, Chastre J, Vuagnat A, Trouillet JL, Novara A, Gibert C. Nosocomial pneumonia and mortality among patients in intensive care units. JAMA 1996, 275:866-869. 10.1001/jama.275.11.866, 8596225.
36. Garrouste-Orgeas M, Chevret S, Arlet G, Marie O, Rouveau M, Popoff N, Schlemmer B. Oropharyngeal or gastric colonization and nosocomial pneumonia in adult intensive care unit patients. A prospective study based on genomic DNA analysis. Am J Respir Crit Care Med 1997, 156:1647-1656.
37. Ibrahim EH, Ward S, Sherman G, Kollef MH. A comparative analysis of patients with early-onset vs late-onset nosocomial pneumonia in the ICU setting. Chest 2000, 117:1434-1442. 10.1378/chest.117.5.1434, 10807834.
38. Ibrahim EH, Tracy L, Hill C, Fraser VJ, Kollef MH. The occurrence of ventilator-associated pneumonia in a community hospital: risk factors and clinical outcomes. Chest 2001, 120:555-561. 10.1378/chest.120.2.555, 11502658.
39. Jacobs S, Chang RW, Lee B, Bartlett FW. Continuous enteral feeding: a major cause of pneumonia among ventilated intensive care unit patients. JPEN J Parenter Enteral Nutr 1990, 14:353-356. 10.1177/0148607190014004353, 2119441.
40. Jimenez P, Torres A, Rodriguez-Roisin R, de la Bellacasa JP, Aznar R, Gatell JM, Agusti-Vidal A. Incidence and etiology of pneumonia acquired during mechanical ventilation. Crit Care Med 1989, 17:882-885. 10.1097/00003246-198909000-00007, 2766759.
41. Kanafani ZA, Kara L, Hayek S, Kanj SS. Ventilator-associated pneumonia at a tertiary-care center in a developing country: incidence, microbiology, and susceptibility patterns of isolated microorganisms. Infect Control Hosp Epidemiol 2003, 24:864-869. 10.1086/502151, 14649777.
42. Kappstein I, Schulgen G, Beyer U, Geiger K, Schumacher M, Daschner FD. Prolongation of hospital stay and extra costs due to ventilator-associated pneumonia in an intensive care unit. Eur J Clin Microbiol Infect Dis 1992, 11:504-508. 10.1007/BF01960804, 1526233.
43. Kingston GW, Phang PT, Leathley MJ. Increased incidence of nosocomial pneumonia in mechanically ventilated patients with subclinical aspiration. Am J Surg 1991, 161:589-592. 10.1016/0002-9610(91)90906-T, 1903241.
44. Kollef MH. Ventilator-associated pneumonia. A multivariate analysis. JAMA 1993, 270:1965-1970. 10.1001/jama.270.16.1965, 8411554.
45. Kollef MH, Silver P, Murphy DM, Trovillion E. The effect of late-onset ventilator-associated pneumonia in determining patient mortality. Chest 1995, 108:1655-1662. 10.1378/chest.108.6.1655, 7497777.
46. Kollef MH, Von Harz B, Prentice D, Shapiro SD, Silver P, St John R, Trovillion E. Patient transport from intensive care increases the risk of developing ventilator-associated pneumonia. Chest 1997, 112:765-773. 10.1378/chest.112.3.765, 9315813.
47. Langer M, Mosconi P, Cigada M, Mandelli M. Long-term respiratory support and risk of pneumonia in critically ill patients. Intensive Care Unit Group of Infection Control. Am Rev Respir Dis 1989, 140:302-305.
48. Mauritz W, Graninger W, Schindler I, Karner J, Zadrobilek E, Sporn P. [Pathogenic flora in the gastric juice and bronchial secretion of long-term ventilated intensive-care patients]. Anaesthesist 1985, 34:203-207.
49. Memish ZA, Cunningham G, Oni GA, Djazmati W. The incidence and risk factors of ventilator-associated pneumonia in a Riyadh hospital. Infect Control Hosp Epidemiol 2000, 21:271-273. 10.1086/501758, 10782591.
50. Moine P, Timsit JF, De Lassence A, Troche G, Fosse JP, Alberti C, Cohen Y. Mortality associated with late-onset pneumonia in the intensive care unit: results of a multi-center cohort study. Intensive Care Med 2002, 28:154-163. 10.1007/s00134-001-1172-7, 11907658.
51. Papazian L, Bregeon F, Thirion X, Gregoire R, Saux P, Denis JP, Perin G, Charrel J, Dumon JF, Affray JP, Gouin F. Effect of ventilator-associated pneumonia on mortality and morbidity. Am J Respir Crit Care Med 1996, 154:91-97.
52. Rashkin MC, Davis T. Acute complications of endotracheal intubation. Relationship to reintubation, route, urgency, and duration. Chest 1986, 89:165-167. 10.1378/chest.89.2.165, 3943375.
53. Rello J, Quintana E, Ausina V, Castella J, Luquin M, Net A, Prats G. Incidence, etiology, and outcome of nosocomial pneumonia in mechanically ventilated patients. Chest 1991, 100:439-444. 10.1378/chest.100.2.439, 1864118.
54. Rello J, Ausina V, Ricart M, Puzo C, Net A, Prats G. Nosocomial respiratory tract infections in multiple trauma patients. Influence of level of consciousness with implications for therapy. Chest 1992, 102:525-529. 10.1378/chest.102.2.525, 1643942.
55. Rello J, Ausina V, Ricart M, Puzo C, Quintana E, Net A, Prats G. Risk factors for infection by Pseudomonas aeruginosa in patients with ventilator-associated pneumonia. Intensive Care Med 1994, 20:193-198. 10.1007/BF01704699, 8014285.
56. Rello J, Sonora R, Jubert P, Artigas A, Rue M, Valles J. Pneumonia in intubated patients: role of respiratory airway. Care. Am J Respir Crit Care Med 1996, 154:111-115.
57. Rodriguez JL, Gibbons KJ, Bitzer LG, Dechert RE, Steinberg SM, Flint LM. Pneumonia: incidence, risk factors, and outcome in injured patients. J Trauma 1991, 31:907-912. 10.1097/00005373-199107000-00005, 2072428.
58. Ruiz-Santana S, Garcia Jimenez A, Esteban A, Guerra L, Alvarez B, Corcia S, Gudin J, Martinez A, Quintana E, Armengol S, et al. ICU pneumonias: a multi-institutional study. Crit Care Med 1987, 15:930-932. 10.1097/00003246-198710000-00007, 3652708.
59. Salata RA, Lederman MM, Shlaes DM, Jacobs MR, Eckstein E, Tweardy D, Toossi Z, Chmielewski R, Marino J, King CH, et al. Diagnosis of nosocomial pneumonia in intubated, intensive care unit patients. Am Rev Respir Dis 1987, 135:426-432.
60. Sofianou DC, Constandinidis TC, Yannacou M, Anastasiou H, Sofianos E. Analysis of risk factors for ventilator-associated pneumonia in a multidisciplinary intensive care unit. Eur J Clin Microbiol Infect Dis 2000, 19:460-463. 10.1007/s100960000236, 10947222.
61. Tejada Artigas A, Bello Dronda S, Chacon Valles E, Munoz Marco J, Villuendas Uson MC, Figueras P, Suarez FJ, Hernandez A. Risk factors for nosocomial pneumonia in critically ill trauma patients. Crit Care Med 2001, 29:304-309. 10.1097/00003246-200102000-00015, 11246310.
62. Timsit JF, Chevret S, Valcke J, Misset B, Renaud B, Goldstein FW, Vaury P, Carlet J. Mortality of nosocomial pneumonia in ventilated patients: influence of diagnostic tools. Am J Respir Crit Care Med 1996, 154:116-123.
63. Torres A, Aznar R, Gatell JM, Jimenez P, Gonzalez J, Ferrer A, Celis R, Rodriguez-Roisin R. Incidence, risk, and prognosis factors of nosocomial pneumonia in mechanically ventilated patients. Am Rev Respir Dis 1990, 142:523-528.
64. Adams DH, Hughes M, Elliott TS. Microbial colonization of closed-system suction catheters used in liver transplant patients. Intensive Crit Care Nurs 1997, 13:72-76. 10.1016/S0964-3397(97)80135-8, 9180492.
65. Ben-Menachem T, Fogel R, Patel RV, Touchette M, Zarowitz BJ, Hadzijahic N, Divine G, Verter J, Bresalier RS. Prophylaxis for stress-related gastric hemorrhage in the medical intensive care unit. A randomized, controlled, single-blind study. Ann Intern Med 1994, 121:568-575.
66. Boots RJ, George N, Faoagali JL, Druery J, Dean K, Heller RF. Double-heater-wire circuits and heat-and-moisture exchangers and the risk of ventilator-associated pneumonia. Crit Care Med 2006, 34:687-693. 10.1097/01.CCM.0000201887.51076.31, 16505654.
67. Boots RJ, Howe S, George N, Harris FM, Faoagali J. Clinical utility of hygroscopic heat and moisture exchangers in intensive care patients. Crit Care Med 1997, 25:1707-1712. 10.1097/00003246-199710000-00021, 9377886.
68. Branson RD, Davis K, Brown R. Comparison of three humidification techniques during mechanical ventilation: Patient selection, cost, and infection considerations. Respir Care 1996, 41:809-816.
69. Combes P, Fauvage B, Oleyer C. Nosocomial pneumonia in mechanically ventilated patients, a prospective randomised evaluation of the Stericath closed suctioning system. Intensive Care Med 2000, 26:878-882. 10.1007/s001340051276, 10990101.
70. Conrad SA, Gabrielli A, Margolis B, Quartin A, Hata JS, Frank WO, Bagin RG, Rock JA, Hepburn B, Laine L. Randomized, double-blind comparison of immediate-release omeprazole oral suspension versus intravenous cimetidine for the prevention of upper gastrointestinal bleeding in critically ill patients. Crit Care Med 2005, 33:760-765. 10.1097/01.CCM.0000157751.92249.32, 15818102.
71. Cook D, Guyatt G, Marshall J, Leasa D, Fuller H, Hall R, Peters S, Rutledge F, Griffith L, Mclellan A, et al. A comparison of sucralfate and ranitidine for the prevention of upper gastrointestinal bleeding in patients requiring mechanical ventilation. Canadian Critical Care Trials Group. N Engl J Med 1998, 338:791-797. 10.1056/NEJM199803193381203, 9504939.
72. Deppe SA, Kelly JW, Thoi LL, Chudy JH, Longfield RN, Ducey JP, Truwit CL, Antopol MR. Incidence of colonization, nosocomial pneumonia, and mortality in critically ill patients using a Trach Care closed-suction system versus an open-suction system: prospective, randomized study. Crit Care Med 1990, 18:1389-1393. 10.1097/00003246-199012000-00016, 2245613.
73. Dreyfuss D, Djedaini K, Gros I, Mier L, Le Bourdelles G, Cohen Y, Estagnasie P, Coste F, Boussougant Y. Mechanical ventilation with heated humidifiers or heat and moisture exchangers: effects on patient colonization and incidence of nosocomial pneumonia. Am J Respir Crit Care Med 1995, 151:986-992.
74. Eddleston JM, Vohra A, Scott P, Tooth JA, Pearson RC, McCloy RF, Morton AK, Doran BH. A comparison of the frequency of stress ulceration and secondary pneumonia in sucralfate- or ranitidine-treated intensive care unit patients. Crit Care Med 1991, 19:1491-1496. 10.1097/00003246-199112000-00009, 1959368.
75. Eddleston JM, Pearson RC, Holland J, Tooth JA, Vohra A, Doran BH. Prospective endoscopic study of stress erosions and ulcers in critically ill adult patients treated with either sucralfate or placebo. Crit Care Med 1994, 22:1949-1954.
76. Hanisch EW, Encke A, Naujoks F, Windolf J. A randomized, double-blind trial for stress ulcer prophylaxis shows no evidence of increased pneumonia. Am J Surg 1998, 176:453-457. 10.1016/S0002-9610(98)00239-6, 9874432.
77. Hurni JM, Feihl F, Lazor R, Leuenberger P, Perret C. Safety of combined heat and moisture exchanger filters in long-term mechanical ventilation. Chest 1997, 111:686-691. 10.1378/chest.111.3.686, 9118709.
78. Johnson KL, Kearney PA, Johnson SB, Niblett JB, MacMillan NL, McClain RE. Closed versus open endotracheal suctioning: costs and physiologic consequences. Crit Care Med 1994, 22:658-666. 10.1097/00003246-199404000-00023, 8143475.
79. Kirton OC, DeHaven B, Morgan J, Morejon O, Civetta J. A prospective, randomized comparison of an in-line heat moisture exchange filter and heated wire humidifiers: rates of ventilator-associated early-onset (community-acquired) or late-onset (hospital-acquired) pneumonia and incidence of endotracheal tube occlusion. Chest 1997, 112:1055-1059. 10.1378/chest.112.4.1055, 9377917.
80. Kollef MH, Shapiro SD, Boyd V, Silver P, Von Harz B, Trovillion E, Prentice D. A randomized clinical trial comparing an extended-use hygroscopic condenser humidifier with heated-water humidification in mechanically ventilated patients. Chest 1998, 113:759-767. 10.1378/chest.113.3.759, 9515854.
81. Lacherade JC, Auburtin M, Cerf C, Van de Louw A, Soufir L, Rebufat Y, Rezaiguia S, Ricard JD, Lellouche F, Brun-Buisson C, et al. Impact of humidification systems on ventilator-associated pneumonia: a randomized multicenter trial. Am J Respir Crit Care Med 2005, 172:1276-1282. 10.1164/rccm.200408-1028OC, 16126933.
82. Laggner AN, Lenz K, Base W, Druml W, Schneeweiss B, Grimm G. Prevention of upper gastrointestinal bleeding in long-term ventilated patients. Sucralfate versus ranitidine. Am J Med 1989, 86:81-84. 10.1016/0002-9343(89)90164-2, 2786673.
83. Lorente L, Lecuona M, Martin MM, Garcia C, Mora ML, Sierra A. Ventilator-associated pneumonia using a closed versus an open tracheal suction system. Crit Care Med 2005, 33:115-119. 10.1097/01.CCM.0000150267.40396.90, 15644657.
84. Lorente L, Lecuona M, Jimenez A, Mora ML, Sierra A. Tracheal suction by closed system without daily change versus open system. Intensive Care Med 2006, 32:538-544. 10.1007/s00134-005-0057-6, 16511633.
85. Lorente L, Lecuona M, Jimenez A, Mora ML, Sierra A. Ventilator-associated pneumonia using a heated humidifier or a heat and moisture exchanger: a randomized controlled trial [ISRCTN88724583]. Crit Care 2006, 10:R116. 10.1186/cc5009, 1750976, 16884530.
86. Martin C, Perrin G, Gevaudan MJ, Saux P, Gouin F. Heat and moisture exchangers and vaporizing humidifiers in the intensive care unit. Chest 1990, 97:144-149. 10.1378/chest.97.1.144, 2295234.
87. Memish ZA, Oni GA, Djazmati W, Cunningham G, Mah MW. A randomized clinical trial to compare the effects of a heat and moisture exchanger with a heated humidifying system on the occurrence rate of ventilator-associated pneumonia. Am J Infect Control 2001, 29:301-305. 10.1067/mic.2001.115404, 11584255.
88. Metz CA, Livingston DH, Smith JS, Larson GM, Wilson TH. Impact of multiple risk factors and ranitidine prophylaxis on the development of stress-related upper gastrointestinal bleeding: a prospective, multicenter, double-blind, randomized trial. The Ranitidine Head Injury Study Group. Crit Care Med 1993, 21:1844-1849. 10.1097/00003246-199312000-00010, 8252888.
89. Mustafa NA, Akturk G, Ozen I, Koksal I, Erciyes N, Solak M. Acute stress bleeding prophylaxis with sucralfate versus ranitidine and incidence of secondary pneumonia in intensive care unit patients. Intensive Care Med 1995, 21:287. 10.1007/BF01701491, 7790623.
90. O'Keefe GE, Gentilello LM, Maier RV. Incidence of infectious complications associated with the use of histamine2-receptor antagonists in critically ill trauma patients. Ann Surg 1998, 227:120-125. 1191181, 9445119.
91. Pickworth KK, Falcone RE, Hoogeboom JE, Santanello SA. Occurrence of nosocomial pneumonia in mechanically ventilated trauma patients: a comparison of sucralfate and ranitidine. Crit Care Med 1993, 21:1856-1862. 10.1097/00003246-199312000-00012, 8252890.
92. Prod'hom G, Leuenberger P, Koerfer J, Blum A, Chiolero R, Schaller MD, Perret C, Spinnler O, Blondel J, Siegrist H, et al. Nosocomial pneumonia in mechanically ventilated patients receiving antacid, ranitidine, or sucralfate as prophylaxis for stress ulcer. A randomized controlled trial. Ann Intern Med 1994, 120:653-662.
93. Rabitsch W, Kostler WJ, Fiebiger W, Dielacher C, Losert H, Sherif C, Staudinger T, Seper E, Koller W, Daxbock F, et al. Closed suctioning system reduces cross-contamination between bronchial system and gastric juices. Anesth Analg 2004, 99:886-892.
94. Roustan JP, Kienlen J, Aubas P, Aubas S, du Cailar J. Comparison of hydrophobic heat and moisture exchangers with heated humidifier during prolonged mechanical ventilation. Intensive Care Med 1992, 18:97-100. 10.1007/BF01705040, 1613206.
95. Thomason MH, Payseur ES, Hakenewerth AM, Norton HJ, Mehta B, Reeves TR, Moore-Swartz MW, Robbins PI. Nosocomial pneumonia in ventilated trauma patients during stress ulcer prophylaxis with sucralfate, antacid, and ranitidine. J Trauma 1996, 41:503-508. 10.1097/00005373-199609000-00020, 8810971.
96. Topeli A, Harmanci A, Cetinkaya Y, Akdeniz S, Unal S. Comparison of the effect of closed versus open endotracheal suction systems on the development of ventilator-associated pneumonia. J Hosp Infect 2004, 58:14-19. 10.1016/j.jhin.2004.05.005, 15350708.
97. Welte T, Ziesing S, Schulte S, Wagner TO. Incidence of ventilator associated pneumonia in mechnaically ventilated pateints: a comparison of closed versus open endotracheal suctioning [abstract]. Eur Respir J 1997, 10:319.
98. Zeitoun SS, de Barros AL, Diccini S. A prospective, randomized study of ventilator-associated pneumonia in patients using a closed vs. open suction system. J Clin Nurs 2003, 12:484-489. 10.1046/j.1365-2702.2003.00749.x, 12790861.
99. Abele-Horn M, Dauber A, Bauernfeind A, Russwurm W, Seyfarth-Metzger I, Gleich P, Ruckdeschel G. Decrease in nosocomial pneumonia in ventilated patients by selective oropharyngeal decontamination (SOD). Intensive Care Med 1997, 23:187-195. 10.1007/s001340050314, 9069004.
100. Aerdts SJ, van Dalen R, Clasener HA, Festen J, van Lier HJ, Vollaard EJ. Antibiotic prophylaxis of respiratory tract infection in mechanically ventilated patients. A prospective, blinded, randomized trial of the effect of a novel regimen. Chest 1991, 100:783-791. 10.1378/chest.100.3.783, 1889273.
101. Bergmans DC, Bonten MJ, Gaillard CA, Paling JC, van der Geest S, van Tiel FH, Beysens AJ, de Leeuw PW, Stobberingh EE. Prevention of ventilator-associated pneumonia by oral decontamination: a prospective, randomized, double-blind, placebo-controlled study. Am J Respir Crit Care Med 2001, 164:382-388.
102. Blair P, Rowlands BJ, Lowry K, Webb H, Armstrong P, Smilie J. Selective decontamination of the digestive tract: a stratified, randomized, prospective study in a mixed intensive care unit. Surgery 1991, 110:303-309.
103. Boland JP, Sadler DL, Stewart W, Wood DJ, Zerick W, Snodgrass KR. Reduction of nosocomial respiratory tract infections in the multiple trauma patients requiring mechanical ventilation by selective parenteral and enteral antisepsis regimen (SPEAR) in the intensive care. XVII International Congress of Chemotherapy: 1991 1991, Berlin.
104. Brun-Buisson C, Legrand P, Rauss A, Richard C, Montravers F, Besbes M, Meakins JL, Soussy CJ, Lemaire F. Intestinal decontamination for control of nosocomial multiresistant gram-negative bacilli. Study of an outbreak in an intensive care unit. Ann Intern Med 1989, 110:873-881.
105. Camus C, Bellissant E, Sebille V, Perrotin D, Garo B, Legras A, Renault A, Le Corre P, Donnio PY, Gacouin A, et al. Prevention of acquired infections in intubated patients with the combination of two decontamination regimens. Crit Care Med 2005, 33:307-314. 10.1097/01.CCM.0000152224.01949.01, 15699832.
106. Cockerill FR, Muller SR, Anhalt JP, Marsh HM, Farnell MB, Mucha P, Gillespie DJ, Ilstrup DM, Larson-Keller JJ, Thompson RL. Prevention of infection in critically ill patients by selective decontamination of the digestive tract. Ann Intern Med 1992, 117:545-553.
107. Ferrer M, Torres A, Gonzalez J, Puig de la Bellacasa J, el-Ebiary M, Roca M, Gatell JM, Rodriguez-Roisin R. Utility of selective digestive decontamination in mechanically ventilated patients. Ann Intern Med 1994, 120:389-395.
108. Finch RG, Tomlinson P, Holliday M, Sole K, Stack KC, Rocker G. Selective decontamination of the digestive tract (SDD) in the prevention of secondary sepsis in a medical/surgical intensive care unit [abstract]. 1991, 0471. Seventeenth international congress of chemotherapy, Berlin.
109. Gastinne H, Wolff M, Delatour F, Faurisson F, Chevret S. A controlled trial in intensive care units of selective decontamination of the digestive tract with nonabsorbable antibiotics. The French Study Group on Selective Decontamination of the Digestive Tract. N Engl J Med 1992, 326:594-599. 10.1056/NEJM199202273260903, 1734249.
110. Georges B, Mazerolles M, Decun JF, Rouge P, Pomies S, Cougot P. Décontamination digestive sélective résultats d'une étude chez le polytraumatisé. Réanimation Soins Intensifs Médecin d'Urgence 1994, 3:621-627.
111. Hammond JM, Potgieter PD, Saunders GL, Forder AA. Double-blind study of selective decontamination of the digestive tract in intensive care. Lancet 1992, 340:5-9. 10.1016/0140-6736(92)92422-C, 1351620.
112. Jacobs S, Foweraker JE, Roberts SE. Effectiveness of selective decontamination of the digestive tract (SDD) in an ICU with a policy encouraging a low gastric pH. Clin Intens Care 1992, 3:52-58.
113. Kerver AJ, Rommes JH, Mevissen-Verhage EA, Hulstaert PF, Vos A, Verhoef J, Wittebol P. Prevention of colonization and infection in critically ill patients: a prospective randomized study. Crit Care Med 1988, 16:1087-1093. 10.1097/00003246-198811000-00001, 3168500.
114. Korinek AM, Laisne MJ, Nicolas MH, Raskine L, Deroin V, Sanson-Lepors MJ. Selective decontamination of the digestive tract in neurosurgical intensive care unit patients: a double-blind, randomized, placebo-controlled study. Crit Care Med 1993, 21:1466-1473. 10.1097/00003246-199310000-00013, 8403954.
115. Krueger WA, Lenhart FP, Neeser G, Ruckdeschel G, Schreckhase H, Eissner HJ, Forst H, Eckart J, Peter K, Unertl KE. Influence of combined intravenous and topical antibiotic prophylaxis on the incidence of infections, organ dysfunctions, and mortality in critically ill surgical patients: a prospective, stratified, randomized, double-blind, placebo-controlled clinical trial. Am J Respir Crit Care Med 2002, 166:1029-1037. 10.1164/rccm.2105141, 12379544.
116. Laggner AN, Tryba M, Georgopoulos A, Lenz K, Grimm G, Graninger W, Schneeweiss B, Druml W. Oropharyngeal decontamination with gentamicin for long-term ventilated patients on stress ulcer prophylaxis with sucralfate?. Wien Klin Wochenschr 1994, 106:15-19.
117. Lingnau W, Berger J, Javorsky F, Fille M, Allerberger F, Benzer H. Changing bacterial ecology during a five-year period of selective intestinal decontamination. J Hosp Infect 1998, 39:195-206. 10.1016/S0195-6701(98)90258-4, 9699139.
118. Palomar M, Alvarez-Lerma F, Jorda R, Bermejo B, . Catalan Study Group of Nosocomial Pneumonia Prevention Prevention of nosocomial infection in mechanically ventilated patients: selective digestive decontamination versus sucralfate. Clin Intens Care 1997, 8:228-235. Catalan Study Group of Nosocomial Pneumonia Prevention.
119. Pneumatikos I, Koulouras V, Nathanail C, Goe D, Nakos G. Selective decontamination of subglottic area in mechanically ventilated patients with multiple Trauma. Intensive Care Med 2002, 28:432-437. 10.1007/s00134-002-1238-1, 11967597.
120. Pugin J, Auckenthaler R, Lew DP, Suter PM. Oropharyngeal decontamination decreases incidence of ventilator-associated pneumonia. A randomized, placebo-controlled, double-blind clinical trial. JAMA 1991, 265:2704-2710. 10.1001/jama.265.20.2704, 2023353.
121. Quinio B, Albanese J, Bues-Charbit M, Viviand X, Martin C. Selective decontamination of the digestive tract in multiple trauma patients. A prospective double-blind, randomized, placebo-controlled study. Chest 1996, 109:765-772. 10.1378/chest.109.3.765, 8617089.
122. Rocha LA, Martin MJ, Pita S, Paz J, Seco C, Margusino L, Villanueva R, Duran MT. Prevention of nosocomial infection in critically ill patients by selective decontamination of the digestive tract. A randomized, double blind, placebo-controlled study. Intensive Care Med 1992, 18:398-404. 10.1007/BF01694341, 1469177.
123. Rodriguez-Roldan JM, Altuna-Cuesta A, Lopez A, Carrillo A, Garcia J, Leon J, Martinez-Pellus AJ. Prevention of nosocomial lung infection in ventilated patients: use of an antimicrobial pharyngeal nonabsorbable paste. Crit Care Med 1990, 18:1239-1242. 10.1097/00003246-199011000-00011, 2225893.
124. Sanchez Garcia M, Cambronero Galache JA, Lopez Diaz J, Cerda Cerda E, Rubio Blasco J, Gomez Aguinaga MA, Nunez Reiz A, Rogero Marin S, Onoro Canaveral JJ, Sacristan del Castillo JA. Effectiveness and cost of selective decontamination of the digestive tract in critically ill intubated patients. A randomized, double-blind, placebo-controlled, multicenter trial. Am J Respir Crit Care Med 1998, 158:908-916.
125. Stoutenbeek CP, van Saene HKF, Zandstra DF. Prevention of multiple organ failure by selective decontamination of the digestive tract in multiple trauma patients. The Immune Consequences of Shock, Trauma and Sepsis 1996, 2:1055-1066. Lengerich: Pabst Science, Faist E, Baue AE, Schildberg FW.
126. Stoutenbeek CP, van Saene HK, Miranda DR, Zandstra DF. The effect of selective decontamination of the digestive tract on mortality in multiple trauma patients: a multicenter randomized controlled trial. Intensive Care Med 2007, 33:261-270. 10.1007/s00134-006-0455-4, 17146635.
127. Ulrich C, Harinck-de Weerd JE, Bakker NC, Jacz K, Doornbos L, de Ridder VA. Selective decontamination of the digestive tract with norfloxacin in the prevention of ICU-acquired infections: a prospective randomized study. Intensive Care Med 1989, 15:424-431. 10.1007/BF00255597, 2689493.
128. Unertl K, Ruckdeschel G, Selbmann HK, Jensen U, Forst H, Lenhart FP, Peter K. Prevention of colonization and respiratory infections in long-term ventilated patients by local antimicrobial prophylaxis. Intensive Care Med 1987, 13:106-113. 10.1007/BF00254795, 3033040.
129. Verwaest C, Verhaegen J, Ferdinande P, Schetz M, Van den Berghe G, Verbist L, Lauwers P. Randomized, controlled trial of selective digestive decontamination in 600 mechanically ventilated patients in a multidisciplinary intensive care unit. Crit Care Med 1997, 25:63-71. 10.1097/00003246-199701000-00014, 8989178.
130. Wiener J, Itokazu G, Nathan C, Kabins SA, Weinstein RA. A randomized, double-blind, placebo-controlled trial of selective digestive decontamination in a medical-surgical intensive care unit. Clin Infect Dis 1995, 20:861-867.
131. Winter R, Humphreys H, Pick A, MacGowan AP, Willatts SM, Speller DC. A controlled trial of selective decontamination of the digestive tract in intensive care and its effect on nosocomial infection. J Antimicrob Chemother 1992, 30:73-87. 10.1093/jac/30.1.73, 1429339.
132. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003, 327:557-560. 10.1136/bmj.327.7414.557, 192859, 12958120.
133. Iezzoni LI. The risks of risk adjustment. JAMA 1997, 278:1600-1607. 10.1001/jama.278.19.1600, 9370507.
134. Hurley JC. Prophylaxis with enteral antibiotics in ventilated patients: selective decontamination or selective cross-infection?. Antimicrob Agents Chemother 1995, 39:941-947. 162658, 7786000.
135. Morris AC, Kefala K, Simpson AJ, Wilkinson TS, Everingham K, Kerslake D, Raby S, Laurenson IF, Swann DG, Walsh TS. Evaluation of the effect of diagnostic methodology on the reported incidence of ventilator-associated pneumonia. Thorax 2009, 64:516-522. 10.1136/thx.2008.110239, 19213771.
136. Delaney A, Gray H, Laupland KB, Zuege DJ. Kinetic bed therapy to prevent nosocomial pneumonia in mechanically ventilated patients: a systematic review and meta-analysis. Crit Care 2006, 10:R70. 10.1186/cc4912, 1550950, 16684365.
137. Chlebicki MP, Safdar N. Topical chlorhexidine for prevention of ventilator-associated pneumonia: a meta-analysis. Crit Care Med 2007, 35:595-602. 10.1097/01.CCM.0000253395.70708.AC, 17205028.
138. Hurley JC. Individual patient data meta-analysis in intensive care medicine and contextual effects. Intensive Care Med 2010, 36:903-904. 10.1007/s00134-010-1812-x, 20232051.
139. Cook DJ, Walter SD, Cook RJ, Griffith LE, Guyatt GH, Leasa D, Jaeschke RZ, Brun-Buisson C, . for the Canadian Critical Care Trails Group Incidence of and risk factors for ventilator-associated pneumonia in critically ill patients. Ann Intern Med 1998, 129:433-440. for the Canadian Critical Care Trails Group.
140. Hurley JC. Inapparent outbreaks of ventilator-associated pneumonia: an ecologic analysis of prevention and cohort studies. Infect Control Hosp Epidemiol 2005, 26:374-390. 10.1086/502555, 15865274.
141. Ebner W, Kropec-Hubner A, Daschner FD. Bacterial resistance and overgrowth due to selective decontamination of the digestive tract. Eur J Clin Microbiol Infect Dis 2000, 19:243-247. 10.1007/s100960050470, 10834811.
142. Saunders GL, Hammond JM, Potgieter PD, Plumb HA, Forder AA. Microbiological surveillance during selective decontamination of the digestive tract (SDD). J Antimicrob Chemother 1994, 34:529-544. 10.1093/jac/34.4.529, 7868405.
143. Merrer J, Santoli F, Appere de Vecchi C, Tran B, De Jonghe B, Outin H. "Colonization pressure" and risk of acquisition of methicillin-resistant Staphylococcus aureus in a medical intensive care unit. Infect Control Hosp Epidemiol 2000, 21:718-723. 10.1086/501721, 11089656.