Management of Ventilator-Associated Pneumonia: Guidelines.

Abstract:

:Two recent major guidelines on diagnosis and treatment of ventilator-associated pneumonia (VAP) recommend consideration of local antibiotic resistance patterns and individual patient risks for resistant pathogens when formulating an initial empiric antibiotic regimen. One recommends against invasive diagnostic techniques with quantitative cultures to determine the cause of VAP; the other recommends either invasive or noninvasive techniques. Both guidelines recommend short-course therapy be used for most patients with VAP. Although neither guideline recommends use of procalcitonin as an adjunct to clinical judgment when diagnosing VAP, they differ with respect to use of serial procalcitonin to shorten the length of antibiotic treatment.

journal_name

Clin Chest Med

authors

Metersky ML,Kalil AC

doi

10.1016/j.ccm.2018.08.002

subject

Has Abstract

pub_date

2018-12-01 00:00:00

pages

797-808

issue

4

eissn

0272-5231

issn

1557-8216

pii

S0272-5231(18)30090-X

journal_volume

39

pub_type

杂志文章,评审
  • Pathobiology of pulmonary hypertension. The role of platelets and thrombosis.

    abstract::With the rare exceptions of PAH associated with antiphospholipid antibodies, genetic platelet dysfunction, or inherited deficiencies of antithrombotic pathways, the thrombotic lesions are secondary, but frequently occurring, in most cases of primary or secondary PAH. Pulmonary arterial hypertension is associated with ...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0272-5231(05)70283-5

    authors: Herve P,Humbert M,Sitbon O,Parent F,Nunes H,Legal C,Garcia G,Simonneau G

    更新日期:2001-09-01 00:00:00

  • Approaches to the treatment of initial Pseudomonas aeruginosa infection in children who have cystic fibrosis.

    abstract::Pseudomonas aeruginosa remains an important cause of pulmonary disease in patients who have cystic fibrosis. The development of antimicrobial therapy directed against this organism has resulted in the preservation of lung function and improved longevity. Efficacy has been demonstrated with agents administered via pare...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccm.2007.02.003

    authors: Lahiri T

    更新日期:2007-06-01 00:00:00

  • Viral Pneumonia in Patients with Hematopoietic Cell Transplantation and Hematologic Malignancies.

    abstract::Viral pneumonia is a common complication for patients with hematologic malignancies and after hematopoietic cell transplantation causing significant morbidity, and often mortality. Infections are predominantly caused by herpes viruses, either by reactivation of latent infection, or less commonly primary infection, or ...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccm.2016.12.009

    authors: Green ML

    更新日期:2017-06-01 00:00:00

  • Cognitive impairment in the intensive care unit.

    abstract::Delirium is a frequent complication in older patients in the ICU and often persists beyond their ICU stay. Delirium in older persons in the ICU is a dynamic and complex process. There is a high prevalence of pre-existing cognitive impairment in patients who are admitted to the medical ICU. This pre-existing cognitive ...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0272-5231(03)00092-3

    authors: Pisani MA,McNicoll L,Inouye SK

    更新日期:2003-12-01 00:00:00

  • Pharmacotherapy of respiratory muscles.

    abstract::This article assesses the role of pharmacotherapy in the management of respiratory muscle dysfunction. It focuses on two classes of drugs, the methylxanthines and the sympathomimetic agents. A prospective section focuses also on the particularities of the diaphragm among the skeletal striated muscles. In addition, a n...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Aubier M

    更新日期:1988-06-01 00:00:00

  • Physiological effects of diaphragm muscle denervation and disuse.

    abstract::From our studies, it is clear that diaphragm muscle neuromotor control is responsive to alterations in innervation and activation. These adaptations to altered use appear to be most pronounced among fast-twitch motor units composed of type II muscle fibers. Because the plasticity involves diminished contractile streng...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Sieck GC

    更新日期:1994-12-01 00:00:00

  • Options for mechanical ventilation in neuromuscular diseases.

    abstract::A variety of mechanical devices may be used to provide assistance when ventilation and cough are severely impaired by progressive respiratory weakness caused by neuromuscular disease. Traditionally, positive pressure ventilation via a tracheostomy has been used, but if upper airway function is adequate, a variety of n...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Unterborn JN,Hill NS

    更新日期:1994-12-01 00:00:00

  • Respiratory infection in the chronically critically ill patient. Ventilator-associated pneumonia and tracheobronchitis.

    abstract::The long-term ventilated patient is at high risk for developing nosocomial pneumonia or tracheobronchitis. In general, the frequency of infection increases with the duration of mechanical ventilation, but the risk appears to be greatest in the first week of intubation. Although these types of infection are common and ...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0272-5231(05)70026-5

    authors: Ahmed QA,Niederman MS

    更新日期:2001-03-01 00:00:00

  • Hypersensitivity pneumonitis: a multifaceted deceiving disorder.

    abstract::Hypersensitivity pneumonitis (HP) represents a group of immunologically mediated lung disorders provoked by recurrent exposure to various environmental agents. HP is multifaceted and may mimic almost any interstitial lung disease, some infectious diseases,and even bronchiolar disorders. In the absence of a diagnostic ...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccm.2004.04.001

    authors: Selman M

    更新日期:2004-09-01 00:00:00

  • Ventilatory strategies in the management of the adult respiratory distress syndrome.

    abstract::This article review available strategies for mechanically ventilating patients with the adult respiratory distress syndrome. The authors first present the conventional strategies of mechanical ventilation: volume-limited mechanical ventilation with positive end-expiratory pressure (PEEP) at normal inspiratory-expirato...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Stoller JK,Kacmarek RM

    更新日期:1990-12-01 00:00:00

  • Role of bronchoscopy in massive hemoptysis.

    abstract::Massive hemoptysis accounts for a minority of all patients with hemoptysis but poses a major challenge for the acute and long-term treatment. Massive hemoptysis can lead to asphyxiation and airway obstruction, shock, and exsanguination. Bronchoscopy plays an integral part in managing massive hemoptysis in diagnosis an...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0272-5231(05)70129-5

    authors: Dweik RA,Stoller JK

    更新日期:1999-03-01 00:00:00

  • Mediators and mechanisms of acute lung injury.

    abstract::Since last reviewed in this forum, there have been remarkable advances in our understanding of the acute inflammatory process and how it contributes to the development of ALI. As stated in the beginning of this article, it is not possible to even begin to review all the specific advances that have been made. Instead, ...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0272-5231(05)70159-3

    authors: Parsons PE

    更新日期:2000-09-01 00:00:00

  • Impact of the aging pulmonary system on the response to exercise.

    abstract::The older adult demonstrates several alterations in the ventilatory response to exercise relative to the young adult. These differences are primarily caused by the aging-induced loss of elastic recoil of the lung, which reduces expiratory airflow rates along the effort-independent portion of the maximal volitional flo...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Johnson BD,Badr MS,Dempsey JA

    更新日期:1994-06-01 00:00:00

  • Noninfectious pulmonary complications after lung transplantation.

    abstract::This article reviews several important noninfectious pulmonary complications that threaten survival, pulmonary function, and quality of life after lung transplantation. Topics reviewed include primary graft dysfunction (PGD), native lung hyperinflation, anastomotic complications, phrenic nerve injury, pleural complica...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccm.2005.06.006

    authors: Ahya VN,Kawut SM

    更新日期:2005-12-01 00:00:00

  • Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease: Benefits and Risks.

    abstract::Inhaled corticosteroids (ICSs), when used in combination with long-acting bronchodilators, reduce the risk of exacerbations and improve health-related quality of life in patients with chronic obstructive pulmonary disease (COPD) compared with bronchodilator or ICS therapy alone. Potential side effects of ICSs include ...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccm.2020.05.006

    authors: Mkorombindo T,Dransfield MT

    更新日期:2020-09-01 00:00:00

  • Extrapulmonary tuberculosis in high prevalence of tuberculosis and low prevalence of HIV.

    abstract::The authors' data show a higher rate of pleural and meningeal involvement among extrapulmonary TB cases than expected by previous works. Special attention should be given to tuberculous meningitis cases among all extrapulmonary TB cases because of its high mortality rate. The most common extrapulmonary involvement is ...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章

    doi:10.1016/s0272-5231(02)00002-3

    authors: Ozbay B,Uzun K

    更新日期:2002-06-01 00:00:00

  • Pneumonia caused by Mycoplasma pneumoniae infection.

    abstract::The features characterizing pneumonia due to Mycoplasma pneumoniae are described. Typical cases, along with chest radiographs of laboratory-documented cases, are presented. ...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Luby JP

    更新日期:1991-06-01 00:00:00

  • Chest physiotherapy techniques in bronchiectasis.

    abstract::Bronchiectasis is a persistent and progressive condition characterized by inflammation and infection causing damage that potentiates impaired mucociliary clearance. The rationale for promoting airway clearance is so that purulent secretions are removed from the airways, ameliorating the inflammation and improving cont...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccm.2012.02.009

    authors: Flude LJ,Agent P,Bilton D

    更新日期:2012-06-01 00:00:00

  • Documentation in bronchology.

    abstract::With the performance of more endoscopic procedures and newly developed diagnostic and therapeutic modalities, a wealth of information around the actual procedure is created. To date, accepted guidelines for standardized documentation are lacking. The authors present recommendations for minimal guidelines that may help...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0272-5231(05)70051-4

    authors: Ernst A,Becker HD

    更新日期:2001-06-01 00:00:00

  • Nontuberculous Mycobacterial Infections in Cystic Fibrosis.

    abstract::Nontuberculous mycobacteria (NTM) are important emerging cystic fibrosis (CF) pathogens, with estimates of prevalence ranging from 6% to 13%. Diagnosis of NTM disease in patients with CF is challenging, as the infection may remain indolent in some, without evidence of clinical consequence, whereas other patients suffe...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccm.2015.11.001

    authors: Martiniano SL,Nick JA,Daley CL

    更新日期:2016-03-01 00:00:00

  • "When the pneumonia doesn't get better".

    abstract::Nonresolving pneumonia is a common and frequently misunderstood problem faced by the practicing pulmonologist. While radiographic resolution of most infections is relatively long and lags behind clinical signs of recovery, data suggest that a variety of host defense problems are a consequence of systemic illness and a...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Fein AM,Feinsilver SH,Niederman MS,Fiel S,Pai PB

    更新日期:1987-09-01 00:00:00

  • Early and long-term functional outcomes following lung volume reduction surgery.

    abstract::In the past 3 years, lung volume reduction surgery has become the most controversial topic in the clinical management of patients with emphysema. Although literature has added to the understanding of the procedure, many important issues remain unclear. This article emphasizes functional and basic physiologic changes t...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0272-5231(05)70377-4

    authors: Sciurba FC

    更新日期:1997-06-01 00:00:00

  • Smoking cessation in the elderly patient.

    abstract::An older smoker tends to be asked less often to quit although he or she has much to gain from achieving a nonsmoking status. Multiple barriers may interfere with attempting to quit including nicotine withdrawal, doubted self-efficacy, other smokers in one's environment, or misperceptions of little gain from quitting. ...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Cox JL

    更新日期:1993-09-01 00:00:00

  • Endobronchial Ablative Therapies.

    abstract::Endobronchial ablative therapies, such as mechanical debulking, laser therapy, electrocautery, argon plasma coagulation, cryotherapy, brachytherapy, photodynamic therapy, microdebrider bronchoscopy, resector balloon deobstruction, and intratumoral chemotherapy, are performed through a rigid or flexible bronchoscope in...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccm.2017.11.008

    authors: Bilaçeroğlu S

    更新日期:2018-03-01 00:00:00

  • Prevention and management of venous thromboembolism in pregnancy.

    abstract::Pulmonary thromboembolism is a major cause of maternal mortality. DVT causes significant morbidity in pregnancy and in later life owing to the post-thrombotic syndrome. Obstetricians must have an understanding of the risk factors for VTE, the appropriate use of prophylaxis, the need for objective diagnosis in women wi...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:10.1016/s0272-5231(02)00055-2

    authors: Greer IA

    更新日期:2003-03-01 00:00:00

  • Preventing Transmission of Mycobacterium Tuberculosis-A Refocused Approach.

    abstract::Traditional tuberculosis (TB) infection control focuses on the known patient with TB, usually on appropriate treatment. A refocused, intensified TB infection control approach is presented. Combined with active case finding and rapid molecular diagnostics, an approach called FAST is described as a convenient way to cal...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccm.2019.07.010

    authors: Nardell EA

    更新日期:2019-12-01 00:00:00

  • Novel medical therapies for pulmonary arterial hypertension.

    abstract::Available targeted therapies for pulmonary arterial hypertension are capable only of slowing progression of the disease and a cure remains elusive. However with the improved understanding of the pulmonary vascular remodeling that characterizes the disease, there is optimism that the disconnect between preclinical and ...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccm.2013.08.002

    authors: O'Connell C,O'Callaghan DS,Humbert M

    更新日期:2013-12-01 00:00:00

  • Alternative drug therapy for asthma.

    abstract::Individualized management of asthma requires consideration of single or combined pharmacologic alternatives. This article reviews experimental and clinical data on the efficacy, safety, mode of action, and therapeutic indications for cromolyn and related inhalational compounds; ketotifen; alpha-adrenergic blockers; ca...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Falliers CJ,Tinkelman DG

    更新日期:1986-09-01 00:00:00

  • Intracavitary therapeutics for pleural malignancies.

    abstract::Pleural malignancies are ideal for novel therapeutic approaches because they are invariably fatal. Intrapleural (IP) chemotherapy has only marginal benefit in pleural malignancies, but may prove efficacious with hyperthermic chemotherapy administered in combination with maximal tumor debulking. IP immunotherapies may ...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccm.2013.04.007

    authors: Haas AR,Sterman DH

    更新日期:2013-09-01 00:00:00

  • Lung Cancer Pathology: Current Concepts.

    abstract::Lung cancer can be diagnosed based on histologic biopsy or cytologic specimens. The 2015 World Health Organization Classification of Lung Tumors addressed the diagnosis of lung cancer in resection specimens and in small biopsies and cytology specimens. For these small specimens, diagnostic terms and criteria are recom...

    journal_title:Clinics in chest medicine

    pub_type: 杂志文章,评审

    doi:10.1016/j.ccm.2019.11.001

    authors: Travis WD

    更新日期:2020-03-01 00:00:00