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The outcome of community acquired pneumonia treated on the intensive care unit
M Alkhayer1, P F Jenkins, B D Harrison
1Department of Respiratory Medicine, West Norwich Hospital, Norfolk, U.K.
Insights
Intensive care for severe community-acquired pneumonia significantly improves survival. This multidisciplinary approach, including prolonged mechanical ventilation, is crucial for patients with hypoxemia and respiratory failure.
Area of Science:
- Pulmonology
- Critical Care Medicine
Background:
- Community-acquired pneumonia (CAP) can lead to severe respiratory compromise.
- Hypoxemia and respiratory failure necessitate intensive care interventions.
Purpose of the Study:
- To evaluate the effectiveness of intensive care for patients with severe CAP.
- To assess outcomes for patients requiring mechanical ventilation due to CAP.
Main Methods:
- Retrospective analysis of 18 patients with severe CAP requiring intensive care.
- Intermittent positive pressure ventilation was administered to 17 patients.
Main Results:
- 13 patients survived to hospital discharge, with 12 long-term survivors.
- Mechanical ventilation was initiated within 4 days and lasted up to 34 days.
- Common complications included renal failure and pneumothorax.
Conclusions:
- Intensive care, including prolonged mechanical ventilation, is effective in treating severe CAP and preventing mortality from hypoxemia.
- Approximately 5% of CAP admissions may require intensive care.
- Multidisciplinary, demanding, and potentially prolonged intensive care is vital for these patients.
Abstract:
Eighteen patients with community acquired pneumonia required intensive care for severe or progressive hypoxaemia, rising arterial carbon dioxide tension or respiratory arrest, and 17 received intermittent positive pressure ventilation. Thirteen survived to leave hospital and 12 are long term survivors. Ventilation was started within 4 days of admission in all cases and was continued for up to 34 days; six patients required ventilation for over 3 weeks. The most common medical complication was renal failure. The most common iatrogenic complication was pneumothorax. We believe that all the hypoxic patients would have died from their hypoxia had it not been corrected. We estimated that up to 5% of patients admitted with community acquired pneumonia need intensive care. This study demonstrates the effectiveness of such care, which is multidisciplinary, demanding, and may need to be prolonged.