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

Community-acquired pneumonia (CAP) is a leading cause of mortality worldwide. CAP mortality is driven by the development of sepsis and acute respiratory failure (ARF). We performed a systematic review of the available English literature published in the period 1 January 1997 to 31 August 2017 and fo...

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Autores principales: Vanoni, Nicolò Maria, Carugati, Manuela, Borsa, Noemi, Sotgiu, Giovanni, Saderi, Laura, Gori, Andrea, Mantero, Marco, Aliberti, Stefano, Blasi, Francesco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6359640/
https://www.ncbi.nlm.nih.gov/pubmed/30646626
http://dx.doi.org/10.3390/medsci7010010
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author Vanoni, Nicolò Maria
Carugati, Manuela
Borsa, Noemi
Sotgiu, Giovanni
Saderi, Laura
Gori, Andrea
Mantero, Marco
Aliberti, Stefano
Blasi, Francesco
author_facet Vanoni, Nicolò Maria
Carugati, Manuela
Borsa, Noemi
Sotgiu, Giovanni
Saderi, Laura
Gori, Andrea
Mantero, Marco
Aliberti, Stefano
Blasi, Francesco
author_sort Vanoni, Nicolò Maria
collection PubMed
description Community-acquired pneumonia (CAP) is a leading cause of mortality worldwide. CAP mortality is driven by the development of sepsis and acute respiratory failure (ARF). We performed a systematic review of the available English literature published in the period 1 January 1997 to 31 August 2017 and focused on ARF in CAP. The database searches identified 189 articles—of these, only 29 were retained for data extraction. Of these 29 articles, 12 addressed ARF in CAP without discussing its ventilatory management, while 17 evaluated the ventilatory management of ARF in CAP. In the studies assessing the ventilatory management, the specific treatments addressed were: high-flow nasal cannula (HFNC) (n = 1), continuous positive airway pressure (n = 2), non-invasive ventilation (n = 9), and invasive mechanical ventilation (n = 5). When analyzed, non-invasive ventilation (NIV) success rates ranged from 20% to 76% and they strongly predicted survival, while NIV failure led to an increased risk of adverse outcome. In conclusion, ARF in CAP patients may require both ventilatory and non-ventilatory management. Further research is needed to better evaluate the use of NIV and HFNC in those patients. Alongside the prompt administration of antimicrobials, the potential use of steroids and the implementation of severity scores should also be considered.
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spelling pubmed-63596402019-02-11 Management of Acute Respiratory Failure Due to Community-Acquired Pneumonia: A Systematic Review Vanoni, Nicolò Maria Carugati, Manuela Borsa, Noemi Sotgiu, Giovanni Saderi, Laura Gori, Andrea Mantero, Marco Aliberti, Stefano Blasi, Francesco Med Sci (Basel) Review Community-acquired pneumonia (CAP) is a leading cause of mortality worldwide. CAP mortality is driven by the development of sepsis and acute respiratory failure (ARF). We performed a systematic review of the available English literature published in the period 1 January 1997 to 31 August 2017 and focused on ARF in CAP. The database searches identified 189 articles—of these, only 29 were retained for data extraction. Of these 29 articles, 12 addressed ARF in CAP without discussing its ventilatory management, while 17 evaluated the ventilatory management of ARF in CAP. In the studies assessing the ventilatory management, the specific treatments addressed were: high-flow nasal cannula (HFNC) (n = 1), continuous positive airway pressure (n = 2), non-invasive ventilation (n = 9), and invasive mechanical ventilation (n = 5). When analyzed, non-invasive ventilation (NIV) success rates ranged from 20% to 76% and they strongly predicted survival, while NIV failure led to an increased risk of adverse outcome. In conclusion, ARF in CAP patients may require both ventilatory and non-ventilatory management. Further research is needed to better evaluate the use of NIV and HFNC in those patients. Alongside the prompt administration of antimicrobials, the potential use of steroids and the implementation of severity scores should also be considered. MDPI 2019-01-14 /pmc/articles/PMC6359640/ /pubmed/30646626 http://dx.doi.org/10.3390/medsci7010010 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Vanoni, Nicolò Maria
Carugati, Manuela
Borsa, Noemi
Sotgiu, Giovanni
Saderi, Laura
Gori, Andrea
Mantero, Marco
Aliberti, Stefano
Blasi, Francesco
Management of Acute Respiratory Failure Due to Community-Acquired Pneumonia: A Systematic Review
title Management of Acute Respiratory Failure Due to Community-Acquired Pneumonia: A Systematic Review
title_full Management of Acute Respiratory Failure Due to Community-Acquired Pneumonia: A Systematic Review
title_fullStr Management of Acute Respiratory Failure Due to Community-Acquired Pneumonia: A Systematic Review
title_full_unstemmed Management of Acute Respiratory Failure Due to Community-Acquired Pneumonia: A Systematic Review
title_short Management of Acute Respiratory Failure Due to Community-Acquired Pneumonia: A Systematic Review
title_sort management of acute respiratory failure due to community-acquired pneumonia: a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6359640/
https://www.ncbi.nlm.nih.gov/pubmed/30646626
http://dx.doi.org/10.3390/medsci7010010
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