Pneumonia: A Deadly Disease despite Intensive Care Treatment

Abstract

In a retrospective study of 30 patients with pneumonia treated in the intensive care unit, it was found that cultures from sputum and bronchial secretions did poorly correspond with blood cultures or serological tests. In only 15 of the patients a reliable etiological diagnosis was ever established. Mechanical ventilation was used in 22 patients, usually with a high oxygen need. At the start of this ventilation a significant blood pressure fall and a further pulmonary deterioration was observed. In fatal cases this pulmonary dysfunction was progressive. The overall mortality was 47%. When an FI02 above 0.6 was needed in the ventilator the mortality was 13/14 (93%).

Community Acquired, Nursing Home Acquired and Hospital Acquired Pneumonia: A Five‐Year Review of the Clinical, Bacteriological and Radiological Characteristics

“…Although low in the out-patient set ting, mor tal ity is re ported to be 25% in those re quir ing hos pi tali za tion. High est mor tal ity rates oc cur in the in ten sive care unit (ICU) set ting (4)(5)(6)(7)(8)(9)(10)(11), where it has been re ported to be as high as 47% (12). Higher mor bid ity and mor tal ity were ob served in the eld erly (6,8,13) and in those with con cur rent ill nesses such as chronic obstruc tive pul mo nary dis ease (COPD), dia be tes mel li tus, chronic re nal fail ure, con ges tive heart fail ure and chronic alco hol abuse (6,(8)(9)(10).…”

Cuadro clínico y factores pronósticos de la neumonía adquirida en la comunidad grave en adultos hospitalizados en la unidad de cuidados intensivos

“…Otras características de nuestros pacientes, como el cuadro clínico de presentación y los agentes etiológicos, son semejantes a las de series previas [6][7][8]11,12,[27][28][29][30] . En nuestra población S. pneum oniae fue el agente más frecuente, como en la mayoría de las series anteriores (tabla V).…”

Severe Community-Acquired Pneumonia

“…and this was subsequently supported by other studies 40,41 . The findings of all large series of SCAP showed that over 50% of patients requiring mechanical ventilatory support and around 40% of patients in septic shock will survive 8,9,11,12,14,15,19,20,22,28,30,33,35,42 .…”

“…The next attempt to reduce mortality involved application of life-supporting therapies in intensive care units (ICUs) 5 . It was estimated that between two and 15 people per 1000 per year in various populations suffered from community-acquired pneumonia 3 , and out of the 20% to 40% of patients who had to be hospitalized [6][7][8] , 5% to 36% were managed in ICUs [9][10][11][12][13] . Several studies [14][15][16] in the early 1980s however, indicated that the mortality of patients with severe community-acquired pneumonia was as high as 47 to 76% despite intensive care, and it was questioned whether such patients should be admitted into ICU 17 .…”