Intensive Care Unit Management of Pneumonia

A survey of clinicians regarding respiratory physiotherapy intervention for intubated and mechanically ventilated patients with community‐acquired pneumonia. What is current practice in Australian ICUs?

“…Consolidation also impairs gas exchange as a result of ventilation‐perfusion mismatching and shunt, which causes hypoxaemia to occur . Purulent sputum develops as a result of leukocytes, macrophages, and pathogenic microorganisms in the airways and can cause secondary obstruction if secretions are not adequately cleared, resulting in atelectasis of functional lung units, further impairing gas exchange, and worsening hypoxaemia . Antibiotic therapy is the mainstay of treatment for pneumonia …”

Severe community‐acquired pneumonia: an Australian perspective

“…Several studies have analysed clinical outcomes and prognostic factors in severe CAP. The risk factors most frequently associated with increased mortality by multivariate analysis include septic shock 2,3,7–10 , multilobar 9–12 or bilateral 10 pneumonia on chest X‐ray (CXR), increased age 9–11 , the requirement for mechanical ventilation 4,10,12 , high simplified acute physiology scores or acute physiology and chronic health evaluation scores 7,8, 13 , ineffective initial antimicrobial treatment 7,8,13 acute renal failure or the requirement for dialysis 4,9 , bacteraemia 7 and severe pre‐existing comorbidities 7,11 .…”