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Lookup NU author(s): Emeritus Professor Martin Eccles, Professor Marie Johnston, Dr Stephan Dombrowski
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© 2014 The Author. Background. Evidence supporting selective decontamination of the digestive tract (SDD) is reasonably strong.We set out to determine use in UK critical care units and to compare patient outcomes between units that do and those that do not use SDD. Methods. A total of 250 UK general critical care units were surveyed. Case mix, outcomes, and lengths of stay for admissions to SDD units (with and without an i.v. component) and non-SDD units were compared using data from the Intensive Care National Audit & Research Centre Case Mix Programme database. Results. A responsewas received fromall the 250 critical care units surveyed. Of these, 13 (5.2%) reported using SDD on some or all admissions, and of these, 3 reported using an i.v. component. Dataon284 690 admissions (April 2008 March 2011) fromunits reporting to the ICNARC Case Mix Programme(CMP) were included in the analyses. Admissions to SDD (n=196) and non-SDD (n=9) unitswere a similar case mix with similar infection rates and average lengths of stay in the unit and hospital. There was no difference in risk-adjusted unit or hospital mortality. The rate of unit-acquired infections in blood was significantly lower in SDD units using an i.v. component. Conclusions. Use of SDD in UK critical care is very low. The rate of unit-acquired infections in blood was significantly lower in SDD units using an i.v. component, but did not translate into a difference in acute hospital mortality or length of stay. There is a need to better understand the barriers to adoption of SDD into clinical practice and such work is underway.
Author(s): Canter RR, Harvey SE, Harrison DA, Campbell MK, Rowan KM, Cuthbertson BH, Duncan E, Prior M, Bellingan G, Campbell M, Eccles M, Johnston M, MacLennan G, Ramsay C, Rose L, Rowan K, Shulman R, Dombromski S, Cuthbertson BH
Publication type: Article
Publication status: Published
Journal: British Journal of Anaesthesia
Year: 2014
Volume: 113
Issue: 4
Pages: 610-617
Print publication date: 01/10/2014
Online publication date: 14/05/2014
Acceptance date: 21/01/2014
ISSN (print): 0007-0912
ISSN (electronic): 1471-6771
Publisher: Oxford University Press
URL: https://doi.org/10.1093/bja/aeu108
DOI: 10.1093/bja/aeu108
PubMed id: 24829442
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