scholarly journals PREDICTING THE NEED FOR INVASIVE VENTILATION WITH APACHE IV SCORE IN PATIENTS WITH SEPSIS FROM COMMUNITY ACQUIRED PNEUMONIA

CHEST Journal ◽  
2021 ◽  
Vol 160 (4) ◽  
pp. A1058
Author(s):  
Antony Arumairaj ◽  
Hansang Park ◽  
Julio Valencia ◽  
Thomas Newman ◽  
Imnett Habtes
Keyword(s):  
Community Acquired Pneumonia ◽  
Invasive Ventilation ◽  
Apache Iv

scholarly journals Utilization Trends and Predictors of Non-invasive and Invasive Ventilation During Hospitalization Due to Community-Acquired Pneumonia

Cureus ◽  
2021 ◽  
Author(s):  
Harshil Shah ◽  
Jude ElSaygh ◽  
Abdur Raheem ◽  
Mohammed A Yousuf ◽  
Lac Han Nguyen ◽  
...  
Keyword(s):  
Community Acquired Pneumonia ◽  
Invasive Ventilation ◽  
Non Invasive

scholarly journals Management of Acute Respiratory Failure Due to Community-Acquired Pneumonia: A Systematic Review

2019 ◽  
Vol 7 (1) ◽  
pp. 10 ◽  
Author(s):  
Nicolò Maria Vanoni ◽  
Manuela Carugati ◽  
Noemi Borsa ◽  
Giovanni Sotgiu ◽  
Laura Saderi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Community Acquired Pneumonia ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Increased Risk ◽  
Severity Scores ◽  
Ventilatory Management

Community-acquired pneumonia (CAP) is a leading cause of mortality worldwide. CAP mortality is driven by the development of sepsis and acute respiratory failure (ARF). We performed a systematic review of the available English literature published in the period 1 January 1997 to 31 August 2017 and focused on ARF in CAP. The database searches identified 189 articles—of these, only 29 were retained for data extraction. Of these 29 articles, 12 addressed ARF in CAP without discussing its ventilatory management, while 17 evaluated the ventilatory management of ARF in CAP. In the studies assessing the ventilatory management, the specific treatments addressed were: high-flow nasal cannula (HFNC) (n = 1), continuous positive airway pressure (n = 2), non-invasive ventilation (n = 9), and invasive mechanical ventilation (n = 5). When analyzed, non-invasive ventilation (NIV) success rates ranged from 20% to 76% and they strongly predicted survival, while NIV failure led to an increased risk of adverse outcome. In conclusion, ARF in CAP patients may require both ventilatory and non-ventilatory management. Further research is needed to better evaluate the use of NIV and HFNC in those patients. Alongside the prompt administration of antimicrobials, the potential use of steroids and the implementation of severity scores should also be considered.

scholarly journals Disease Risk and Mortality Prediction in Intensive Care Patients with Pneumonia. Australian and New Zealand Practice in Intensive Care (ANZPIC II)

2005 ◽  
Vol 33 (1) ◽  
pp. 101-111 ◽  
Author(s):  
R. J. Boots ◽  
J. Lipman ◽  
R. Bellomo ◽  
D. Stephens ◽  
R. F. Heller
Keyword(s):  
Intensive Care ◽  
New Zealand ◽  
Clinical Signs ◽  
Community Acquired Pneumonia ◽  
Ventilator Associated Pneumonia ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

This study of ventilated patients investigated pneumonia risk factors and outcome predictors in 476 episodes of pneumonia (48% community-acquired pneumonia, 24% hospital-acquired pneumonia, 28% ventilator-associated pneumonia) using a prospective survey in 14 intensive care units within Australia and New Zealand. For community acquired pneumonia, mortality increased with immunosuppression (OR 5.32, CI 95% 1.58–17.99, P<0.01), clinical signs of consolidation (OR 2.43, CI 95% 1.09–5.44, P=0.03) and Sepsis-Related Organ Failure Assessment (SOFA) scores (OR 1.19, CI 95% 1.08–1.30, P<0.001) but improved if appropriate antibiotic changes were made within three days of intensive care unit admission (OR 0.42, CI 95% 0.20–0.86, P=0.02). For hospital-acquired pneumonia, immunosuppression (OR 6.98, CI 95% 1.16–42.2, P=0.03) and non-metastatic cancer (OR 3.78, CI 95% 1.20–11.93, P=0.02) were the principal mortality predictors. Alcoholism (OR 7.80, CI 95% 1.20–17.50, P<0.001), high SOFA scores (OR 1.44, CI 95% 1.20–1.75, P=0.001) and the isolation of “high risk” organisms including Pseudomonas aeruginosa, Acinetobacter spp, Stenotrophomonas spp and methicillin resistant Staphylococcus aureus (OR 4.79, CI 95% 1.43–16.03, P=0.01), were associated with increased mortality in ventilator-associated pneumonia. The use of non-invasive ventilation was independently protective against mortality for patients with community-acquired and hospital-acquired pneumonia (OR 0.35, CI 95% 0.18–0.68, P=0.002). Mortality was similar for patients requiring both invasive and non-invasive ventilation and non-invasive ventilation alone (21% compared with 20% respectively, P=0.56). Pneumonia risks and mortality predictors in Australian and New Zealand ICUs vary with pneumonia type. A history of alcoholism is a major risk factor for mortality in ventilator-associated pneumonia, greater in magnitude than the mortality effect of immunosuppression in hospital-acquired pneumonia or community-acquired pneumonia. Non-invasive ventilation is associated with reduced ICU mortality. Clinical signs of consolidation worsen, while rationalising antibiotic therapy within three days of ICU admission improves mortality for community-acquired pneumonia patients.

scholarly journals Non-invasive ventilation in the treatment of severe polymicrobial community-acquired pneumonia

2017 ◽  
Vol 11 (1) ◽  
pp. 57
Author(s):  
Enrico Cinque ◽  
Ines Maria Grazia Piroddi ◽  
Cornelius Barlascini ◽  
Alessandro Perazzo ◽  
Antonello Nicolini
Keyword(s):  
Mechanical Ventilation ◽  
Severe Disease ◽  
Invasive Mechanical Ventilation ◽  
Clinical Signs ◽  
Case Series ◽  
Community Acquired Pneumonia ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Increased Risk

Polymicrobial pneumonia may be caused by the combination of respiratory viruses, bacteria and fungi in a host. Colonization by <em>Streptococcus pneumoniae</em> was associated with increased risk of Intensive Care Unit admission or death in the setting of influenza infection, whereas the colonization by methicillin sensible <em>Staphylococcus aureus</em> co-infection was associated with severe disease and death in adults and children. The principal association of pathogens in community-acquired pneumonia (CAP) is bacteria and viral co-infection, and accounts approximately for 39% of microbiological diagnosed cases of CAP. The differential clinical diagnosis between a viral and a bacterial CAP is not easy: no clinical signs or radiological findings help the clinician to suspect to the diagnosis. Patients with polymicrobial infections are more likely to have underlying medical conditions and have more severe outcome. Severe respiratory failure and need of mechanical ventilation occur in several cases. Non invasive ventilation (NIV) use aims to avoid invasive mechanical ventilation. NIV treatment is controversial owing to high reported treatment failure. In this case series we report three cases of severe polymicrobial CAP: all of them required NIV with a good outcome.

Non-invasive ventilation in community-acquired pneumonia and severe acute respiratory failure

2012 ◽  
Vol 38 (3) ◽  
pp. 458-466 ◽  
Author(s):  
Andres Carrillo ◽  
Gumersindo Gonzalez-Diaz ◽  
Miquel Ferrer ◽  
Maria Elena Martinez-Quintana ◽  
Antonia Lopez-Martinez ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Community Acquired Pneumonia ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

Non-invasive ventilation in community acquired pneumonia

2019 ◽  
Vol 37 (1) ◽  
pp. 167
Author(s):  
Funda Sungur Biteker ◽  
Eda Özlek ◽  
Bülent Özlek ◽  
Oğuzhan Çelik ◽  
Cem Çil ◽  
...  
Keyword(s):  
Community Acquired Pneumonia ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

scholarly journals Hospitalizations for Community-Acquired and Non-Ventilator-Associated Hospital-Acquired Pneumonia in Spain: Influence of the Presence of Bronchiectasis. A Retrospective Database Study

2020 ◽  
Vol 9 (8) ◽  
pp. 2339
Author(s):  
Gema Sanchez-Muñoz ◽  
Ana López-de-Andrés ◽  
Valentín Hernández-Barrera ◽  
Fernando Pedraza-Serrano ◽  
Rodrigo Jimenez-Garcia ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Metastatic Cancer ◽  
Length Of Hospital Stay ◽  
Community Acquired Pneumonia ◽  
Invasive Ventilation ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

To examine and compare in-hospital mortality (IHM) of community-acquired pneumonia (CAP) and non-ventilator hospital-acquired pneumonia (NV-HAP) among patients with or without bronchiectasis (BQ) using propensity score matching. A retrospective observational epidemiological study using the Spanish Hospital Discharge Records, 2016–17. We identified 257,455 admissions with CAP (3.97% with BQ) and 17,069 with NV-HAP (2.07% with BQ). Patients with CAP and BQ had less comorbidity, lower IHM, and a longer mean length of hospital stay (p < 0.001) than non-BQ patients. They had a higher number of isolated microorganisms, including Pseudomonas aeruginosa. In patients with BQ and NV-HAP, no differences were observed with respect to comorbidity, in-hospital mortality (IHM), or mean length of stay. P. aeruginosa was more frequent (p = 0.028). IHM for CAP and NV-HAP with BQ was 7.89% and 20.06%, respectively. The factors associated with IHM in CAP with BQ were age, comorbidity, pressure ulcers, surgery, dialysis, and invasive ventilation, whereas in NV-HAP with BQ, the determinants were age, metastatic cancer, need for dialysis, and invasive ventilation. Patients with CAP and BQ have less comorbidity, lower IHM and a longer mean length of hospital stay than non-BQ patients. However, they had a higher number of isolated microorganisms, including Pseudomonas aeruginosa. In patients with BQ and NV-HAP, no differences were observed with respect to comorbidity, in-hospital mortality, or mean length of stay, but they had a greater frequency of infection by P. aeruginosa than non-BQ patients. Predictors of IHM for both types of pneumonia among BQ patients included dialysis and invasive ventilation.

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