Pulmonary Infections in Adults: Nosocomial Pneumonia.

Q3 Medicine
FP essentials Pub Date : 2025-03-01
Thomas M File, Julio A Ramirez
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引用次数: 0

Abstract

Nosocomial pneumonia, which includes hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), is associated with high morbidity and mortality. HAP occurs 48 hours or more after admission and may require intubation and mechanical ventilation. VAP occurs more than 48 hours after mechanical ventilation is initiated. The mortality rate of VAP and ventilated HAP ranges from 15% to 30%, depending on severity. Diagnosis is based on a new pulmonary infiltrate associated with clinical evidence of infection such as new-onset fever, purulent sputum, leukocytosis, and decline in oxygenation. Optimal management includes identification of the causative pathogen, early empiric antimicrobial therapy directed against likely pathogens, and de-escalation of treatment once a pathogen is identified. The standard treatment duration is 7 days for patients who are improving clinically. Effective methods to prevent VAP include washing hands adequately between patient contacts, maintaining semirecumbent patient positioning, avoiding gastric overdistention, providing continuous subglottic suctioning for patients on mechanical ventilation, limiting stress-ulcer prophylaxis, and practicing daily oral care with toothbrushing.

成人肺部感染:院内肺炎。
院内肺炎,包括医院获得性肺炎(HAP)和呼吸机相关性肺炎(VAP),与高发病率和死亡率相关。HAP发生在入院后48小时或更长时间,可能需要插管和机械通气。VAP发生在机械通气启动后48小时以上。根据严重程度,VAP和通气HAP的死亡率从15%到30%不等。诊断是基于新的肺部浸润和感染的临床证据,如新发发热、脓性痰、白细胞增多和氧合下降。最佳管理包括确定致病病原体,针对可能的病原体进行早期经验性抗菌治疗,一旦确定病原体,就降低治疗的升级程度。临床好转的患者,标准疗程为7天。预防VAP的有效方法包括:在患者接触之间充分洗手,保持患者半卧位,避免胃过度膨胀,对机械通气患者提供持续的声门下吸痰,限制应激性溃疡预防,以及日常刷牙口腔护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
FP essentials
FP essentials Medicine-Medicine (all)
CiteScore
1.00
自引率
0.00%
发文量
58
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