D-PRISM: a global survey-based study to assess diagnostic and treatment approaches in pneumonia managed in intensive care
Rattachement africain : co, gb, cn, br, it, Afrique du Sud, us, ae, gr, au, np, de, id, Maroc, my, in, be, jp, tr, qa, ch, fr, sg, Ouganda, pt, dk, es. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: Pneumonia remains a significant global health concern, particularly among those requiring admission to the intensive care unit (ICU). Despite the availability of international guidelines, there remains heterogeneity in clinical management. The D-PRISM study aimed to develop a global overview of how pneumonias (i.e., community-acquired (CAP), hospital-acquired (HAP), and Ventilator-associated pneumonia (VAP)) are diagnosed and treated in the ICU and compare differences in clinical practice worldwide. METHODS: The D-PRISM study was a multinational, survey-based investigation to assess the diagnosis and treatment of pneumonia in the ICU. A self-administered online questionnaire was distributed to intensive care clinicians from 72 countries between September to November 2022. The questionnaire included sections on professional profiles, current clinical practice in diagnosing and managing CAP, HAP, and VAP, and the availability of microbiology diagnostic tests. Multivariable analysis using multiple regression analysis was used to assess the relationship between reported antibiotic duration and organisational variables collected in the study. RESULTS: A total of 1296 valid responses were collected from ICU clinicians, spread between low-and-middle income (LMIC) and high-income countries (HIC), with LMIC respondents comprising 51% of respondents. There is heterogeneity across the diagnostic processes, including clinical assessment, where 30% (389) did not consider radiological evidence essential to diagnose pneumonia, variable collection of microbiological samples, and use and practice in bronchoscopy. Microbiological diagnostics were least frequently available in low and lower-middle-income nation settings. Modal intended antibiotic treatment duration was 5-7 days for all types of pneumonia. Shorter durations of antibiotic treatment were associated with antimicrobial stewardship (AMS) programs, high national income status, and formal intensive care training. CONCLUSIONS: This study highlighted variations in clinical practice and diagnostic capabilities for pneumonia, particularly issues with access to diagnostic tools in LMICs were identified. There is a clear need for improved adherence to existing guidelines and standardized approaches to diagnosing and treating pneumonia in the ICU. Trial registration As a survey of current practice, this study was not registered. It was reviewed and endorsed by the European Society of Intensive Care Medicine.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- D-PRISM: a global survey-based study to assess diagnostic and treatment approaches in pneumonia managed in intensive care
- Date Crossref
- 22/11/2024
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Universidad de La Sabana pays non établi dans la noticeUniversité ou école supérieure
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University of Oxford Pandemic Sciences Institute pays non établi dans la noticeUniversité ou école supérieure
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Sir Run Run Shaw Hospital pays non établi dans la noticeÉtablissement de santé
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Zhejiang University Department of Emergency Medicine pays non établi dans la noticeUniversité ou école supérieure
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Hospital Israelita Albert Einstein pays non établi dans la noticeOrganisme public
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Università Cattolica del Sacro Cuore pays non établi dans la noticeUniversité ou école supérieure
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Agostino Gemelli University Polyclinic pays non établi dans la noticeÉtablissement de santé
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Istituti di Ricovero e Cura a Carattere Scientifico pays non établi dans la noticeÉtablissement de santé
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University of the Witwatersrand University of the Witwatersrand, Afrique du Sud (code pays fourni par la source)Université ou école supérieure
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Johannesburg Hospital Johannesburg Hospital, Afrique du Sud (code pays fourni par la source)Établissement de santé
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University of New Mexico Critical Care and Sleep Medicine pays non établi dans la noticeUniversité ou école supérieure
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Dubai Hospital pays non établi dans la noticeÉtablissement de santé
Universidad de La Sabana, Pandemic Sciences Institute — University of Oxford et Sir Run Run Shaw Hospital, avec 9 autres affiliations. Pays d’affiliation : Afrique du Sud, Maroc, Ouganda.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.