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Preventing Nosocomial Infections to Improve Outcomes of Intensive Care

  • Brun-Buisson C. 
Conference paper
Part of the Update in Intensive Care Medicine book series (UICMSOFT, volume 39)

Abstract

There are few topics that have been subjected to such controversy as the question of the influence of nosocomial infections on outcomes, especially mortality, of critically ill patients. The topic is indeed of importance, since nosocomial infection (similarly to other iatrogenic* events) is a frequent event [1, 2, 3] and probably the most frequent drawback of intensive care, and determining outcomes attributable to nosocomial intensive care unit (ICU)-acquired infections is going to bear heavily on the design and interpretation of studies aimed at prevention or treatment of such infections. Therefore, the question whether prevention of nosocomial infection will result, or not, in improved outcome from intensive care is undermined by the uncertainty surrounding the consequences of infection on outcome. For example, it is apparent that if nosocomial infections do not influence mortality, there is no point in attempting to show a difference in mortality through implementation of a preventive or therapeutic intervention. In this circumstance, the impact of the intervention on other end-points such as length of stay or antibiotic use will be examined, and this has important imphcations in terms of study design and sample size needed. In this chapter, we shall examine the available data for the most common nosocomial infections occurring in ICU patients, in terms of their impact on mortality, length of stay and resource use, including antibiotics when available. Most such studies have focused on specific sites of infection, and these will be examined separately, after a brief overview of the problem. We shall then examine the evidence, if any, regarding to what extent preventing nosocomial infection may impact on outcome of critically ill patients, and the indicators that may be used for the purpose of quality improvement processes and follow-up.

Keywords

Acute Respiratory Distress Syndrome Nosocomial Infection Intensive Care Unit Patient Intensive Care Unit Stay Hand Hygiene 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2003

Authors and Affiliations

  • Brun-Buisson C. 
    • 1
  1. 1.Dept of Intensive CareHôpital Henri MondorCréteilFrance

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