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重症肺炎的管理。

Management of pneumonia in the critically ill.

机构信息

Division of Pulmonary and Critical Care Medicine, Weill Cornell Medical College, New York, NY, USA.

Division of Pulmonary and Critical Care Medicine, Weill Cornell Medical College, New York, NY, USA -

出版信息

Minerva Med. 2023 Oct;114(5):667-682. doi: 10.23736/S0026-4806.22.08467-1. Epub 2023 Jan 26.

Abstract

Pneumonias continue to be major public health issues and are commonly encountered in the intensive care setting. The most common types of pneumonia leading to critical illness include severe community acquired pneumonia, hospital acquired pneumonia, and ventilator associated pneumonia. Early evaluation, diagnosis, and escalation to appropriate levels of care are imperative to improving survival. Treatment remains challenging with the need to balance antibiotic stewardship and minimizing patient harm. As evidenced in the most recent society guidelines, the identification of risk factors for severe disease and the causative pathogens are crucial in guiding the most appropriate therapy.

摘要

肺炎仍然是主要的公共卫生问题,在重症监护环境中也很常见。导致重症的最常见肺炎类型包括严重社区获得性肺炎、医院获得性肺炎和呼吸机相关性肺炎。早期评估、诊断和升级到适当的治疗水平对于提高生存率至关重要。治疗仍然具有挑战性,需要平衡抗生素管理和尽量减少患者伤害。正如最近的指南所证明的,识别严重疾病的危险因素和病原体对于指导最合适的治疗至关重要。

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