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

Vanoni, Nicolò; Carugati, Manuela; Borsa, Noemi; Sotgiu, Giovanni; Saderi, Laura; Gori, Andrea; Mantero, Marco; Aliberti, Stefano; Blasi, Francesco

doi:10.3390/medsci7010010

Cited by 12 publications

(15 citation statements)

References 64 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Acute respiratory failure and the development of sepsis are the main causes of CAP mortality. 15 Long-term hypoxia caused by respiratory failure can lead to ischemic changes and dysfunction of the heart, brain, kidney, and lung and may worsen the outcome of CAP and/or lead to higher mortality. 16…”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14] Acute respiratory failure and the development of sepsis are the main causes of CAP mortality. 15 Long-term hypoxia caused by respiratory failure can lead to ischemic changes and dysfunction of the heart, brain, kidney, and lung and may worsen the outcome of CAP and/or lead to higher mortality. 16 Almiral et al found that the use of oral steroids and immunosuppressive therapy were clear risk factors for CAP, while the role of cancer was not clear.…”

Section: Model Verificationmentioning

confidence: 99%

See 1 more Smart Citation

A Model to Predict In-hospital Mortality in Elderly Patients with Community-acquired Pneumonia: a Retrospective Study

Hao

Zhang

Yan

et al. 2022

Preprint

View full text Add to dashboard Cite

ObjectivesTo develop and validate a predictive model for evaluating in-hospital mortality risk in elderly patients with community-acquired pneumonia.SettingTwo tertiary care hospitals with 2000 beds and 1000 beds respectively in Beijing, China.ParticipantsElderly patients (age ≥ 65 years) with community-acquired pneumonia admitted to the Department of Internal Medicine of the two hospitals from January 2010 to December 2019 or from January 2019 to December 2019 respectively.DesignIt was a retrospective study. After dividing the data set into training and validation sets, we created a mortality model that included patient demographics, hospitalization time, hospital outcome, and various clinical conditions associated with hospitalization. We then applied the model to the validation set.Main outcome measuresIn-hospital mortality.ResultsThe training cohort included 2,466 patients admitted to the one hospital, while the validation cohort included 424 patients at the other hospital. The overall in-hospital mortality rate was 15.6%. In the multivariable model, age, respiratory failure, heart failure, and malignant tumors were associated with mortality. The model had excellent discrimination with AUC values of 0.877 and 0.930 in the training and validation cohorts, respectively.ConclusionsThe predictive model to evaluate in-hospital mortality in elderly patients with community-acquired pneumonia, which was established based on administrative data, provides a simple tool for physicians to assess the prognosis of elderly patients with community-acquired pneumonia in Beijing.Strengths and limitations of this studyThe clinical data collected were obtained from a large retrospective cohort over a 10-year period, resulting in good reliability.The model based on administrative data can help healthcare workers determine the prognosis and outcomes of elderly patients of CAP, especially in resource limited regions in China.Our main outcome was in-hospital mortality, not 30-day mortality or longer.All included cases were collected from inpatient, outpatient and emergency patients were not included.The model was only verified in two hospitals in Beijing and further verification should be conducted in other areas and different levels of hospitals.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Model Verificationmentioning

confidence: 99%

A Model to Predict In-hospital Mortality in Elderly Patients with Community-acquired Pneumonia: a Retrospective Study

Hao

Zhang

Yan

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…In one study, the success of NIMV ranged from 20 to 76% and appeared to correlate with the underlying mechanism, with the greatest benefits in patients with hypercapnic COPD or cardiogenic pulmonary edema. 143 Helmet-delivered continuous positive airway pressure was also proven to ameliorate oxygenation in CAP patients with moderate hypoxemic acute respiratory failure. 144 Oxygen therapy by high-flow nasal cannula (HFNC) is a recently developed simple therapeutic option to deliver high fractions of inspired oxygen (FiO 2 ).…”

Section: Treatment Considerationsmentioning

confidence: 99%

Pneumonic versus Nonpneumonic Exacerbations of Chronic Obstructive Pulmonary Disease

Crisafulli

Manco

Ferrer

et al. 2020

Semin Respir Crit Care Med

View full text Add to dashboard Cite

Patients with chronic obstructive pulmonary disease (COPD) often suffer acute exacerbations (AECOPD) and community-acquired pneumonia (CAP), named nonpneumonic and pneumonic exacerbations of COPD, respectively. Abnormal host defense mechanisms may play a role in the specificity of the systemic inflammatory response. Given the association of this aspect to some biomarkers at admission (e.g., C-reactive protein), it can be used to help to discriminate AECOPD and CAP, especially in cases with doubtful infiltrates and advanced lung impairment. Fever, sputum purulence, chills, and pleuritic pain are typical clinical features of CAP in a patient with COPD, whereas isolated dyspnea at admission has been reported to predict AECOPD. Although CAP may have a worse outcome in terms of mortality (in hospital and short term), length of hospitalization, and early readmission rates, this has only been confirmed in a few prospective studies. There is a lack of methodologically sound research confirming the impact of severe AECOPD and COPD + CAP. Here, we review studies reporting head-to-head comparisons between AECOPD and CAP + COPD in hospitalized patients. We focus on the epidemiology, risk factors, systemic inflammatory response, clinical and microbiological characteristics, outcomes, and treatment approaches. Finally, we briefly discuss some proposals on how we should orient research in the future.

show abstract

“…In the 1980s, the World Health Organization (WHO) developed a case management strategy aiming to reduce deaths from pneumonia (4). While it suggests that in severe pneumonia cases, the cornerstones of management are antibiotic and supportive therapy, the most important basis for the The Effectiveness of Heated Humidified High-flow Nasal Cannula in Children with Severe Bacterial Pneumonia in the Emergency Department DO I: 10.4274/jpr.galenos.2019.15045 management strategy was hypoxemia which is common and potentially associated with increased risk of death (4)(5)(6)(7). Early detection of hypoxemia, and administration of oxygen therapy also improves the outcome of children with SBP (7).…”

Section: Introductionmentioning

confidence: 99%

“…There have been various oxygen treatment options for a long time but these may be insufficient. Heated humidified high-flow nasal cannula (HHHFNC) therapy has recently started to become an alternative oxygen giving method for the treatment of acute RD due to pneumonia (7). HHHFNC can be set up quickly and is a reliable noninvasive respiratory support therapy method (8).…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Heated Humidified High-flow Nasal Cannula in Children with Severe Bacterial Pneumonia in the Emergency Department

Yurtseven¹,

Saz²

2020

jpr

View full text Add to dashboard Cite

The provision of appropriate respiratory support has a great role in outcome of patients presenting to the emergency department (ED) with respiratory distress (RD) associated with severe pneumonia. In recent years, heated humidified high-flow nasal cannula (HHHFNC) therapy has become one of the most popular non-invasive respiratory support modalities in all pediatric settings. In this study, we aimed to assess whether the use of HHHFNC therapy is associated with reduced RD and improvements in hypoxemia among children with severe bacterial pneumonia (SBP) presenting to the ED. Materials and Methods: We performed a prospective observational study of patients with SBP admitted to a tertiary children's hospital pediatric ED who received HHHFNC therapy within the 2 year study period. The primary outcome was accepted as treatment failure (It was defined as a clinical escalation in respiratory status) and an increase in peripheral capillary oxygen saturation (SpO 2). Secondary outcomes covered a decrease of respiratory rate (RR), heart rate (HR), and rates of weaning, intubation and intensive care unit (ICU) admission. Results: Fifty-six patients were included in this analyses. Treatment failure was 21.5% (12/56). Among these patients, 9 (16%) were intubated and 3 (5.5%) placed on bilevel positive airway pressure. The mean initial RR values were significantly higher in the non responders group than the responder group (p=0.027). Significant variation in the intubation rate or the ICU admission rate was not determined. At the 2 nd hour, the fall in RR (p<0.001), HR (p<0.001), and the increase of SpO 2 (p<0.001) were significantly evident when compared with the beginning. Conclusion: HHHFNC therapy reached treatment success in a majority of the patients with SBP and provided an early effect. Patients with higher RRs responded less to HHHFNC. Further larger studies are needed to assess the impact of HHHFNC compared with other possible therapies.

show abstract

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

Cited by 12 publications

References 64 publications

A Model to Predict In-hospital Mortality in Elderly Patients with Community-acquired Pneumonia: a Retrospective Study

A Model to Predict In-hospital Mortality in Elderly Patients with Community-acquired Pneumonia: a Retrospective Study

Pneumonic versus Nonpneumonic Exacerbations of Chronic Obstructive Pulmonary Disease

The Effectiveness of Heated Humidified High-flow Nasal Cannula in Children with Severe Bacterial Pneumonia in the Emergency Department

Contact Info

Product

Resources

About