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Observational study of current use of selective decontamination of the digestive tract in UK Critical Care units

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.

Publication metadata

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


DOI: 10.1093/bja/aeu108

PubMed id: 24829442


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