成年人的肺部感染:鼻腔肺炎
Thomas M File1, Julio A Ramirez2
1Infectious Disease Division - Summa Health, Akron, OH.
医院获得的肺炎 (HAP) 和呼吸机相关的肺炎 (VAP) 是严重的感染. 早期诊断,向抗生素和预防措施是改善患者结果和降低死亡率的关键.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
背景情况:
- 鼻腔肺炎,包括医院获得的肺炎 (HAP) 和呼吸机相关的肺炎 (VAP),具有显著的发病率和死亡率风险.
- HAP和VAP的定义分别取决于它们发生后入院或启动机械通风.
- VAP和通风HAP的死亡率在15%到30%之间,这突显了这些疾病的严重性.
研究的目的:
- 概述医院肺炎的诊断标准.
- 详细说明最佳管理策略,包括病原体识别和抗菌药物治疗.
- 提出基于证据的VAP预防方法.
主要方法:
- 诊断依赖于识别新的肺透,并与感染的临床迹象 (发烧,性吐,白细胞病,低氧化) 相结合.
- 管理涉及及及时的病原体识别和早期的经验性抗生素治疗.
- 基于已识别的病原体和为期7天的标准疗程来缓解治疗升级,以临床改善患者.
主要成果:
- 有效的VAP预防策略包括仔细的手部卫生,病人的定位和口腔护理.
- 淋巴下分泌物排水和明智地使用压力预防非常重要.
- 早期向的抗微生物治疗和降级有助于获得最佳结果.
结论:
- 鼻腔肺炎需要及时诊断和量身定制的管理策略.
- 实施全面的VAP预防协议对于降低感染率至关重要.
- 坚持推的治疗持续时间和缓解升级会改善患者的康复和存活率.
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