Chest
Clinical Investigations in Critical CareSelective Decontamination of the Digestive Tract in Multiple Trauma Patients: A Prospective Double-blind, Randomized, Placebo-Controlled Study
Section snippets
Patients
Multiple trauma patients admitted to the ICU, intubated within 24 h, were enrolled by the staff physicians in a prospective, randomized, double-blind, placebo-controlled fashion. Randomization was performed by the hospital's pharmacists according to a randomized list of consecutive treatment assignments. The study received approval of the Ethics Committee of the University of Marseilles and informed consents were obtained from the patients' families. Criteria for exclusion were age younger than
Results
During the study period, 393 trauma patients were admitted to the ICU, of whom 148 were enrolled in the study and were analyzed on an “intention-to-treat” basis. Their demographic features are shown in Table 1.
Both groups were similar with respect to age, sex ratio, ISS, GCS, SAPS, duration of mechanical ventilation, and duration of ICU stay. The regimen was given for 7.3 ± 5.6 days in the placebo group and 7.1 ± 5.7 days in the treated group. Primary diagnoses of patients on ICU admission were
Discussion
This study of SDD in multiple trauma patients shows a significant reduction of the number of episodes of bronchopneumonia and a reduction in the total charge for antibiotics. There was no reduction in the incidence of other infections. Days in the ICU, duration of mechanical ventilation, and mortality were similar in both groups. Colonization by MRCNS tended to increase in the treated group.
The use of SDD with combined oral nonabsorbable and systemic antibiotics was first reported by
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revision accepted October 20.