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Review

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

1
Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Internal Medicine Department, Respiratory Unit and Adult Cystic Fibrosis Center, 20122 Milan, Italy
2
Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
3
Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Internal Medicine Department, Infectious Diseases Unit, 20122 Milan, Italy
4
Division of Infectious Diseases, Duke University, Durham, NC 27710, USA
5
Clinical Epidemiology and Medical Statistics Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
*
Author to whom correspondence should be addressed.
These two authors contributed equally and are considered first authors for this manuscript.
Med. Sci. 2019, 7(1), 10; https://doi.org/10.3390/medsci7010010
Received: 28 November 2018 / Revised: 3 January 2019 / Accepted: 8 January 2019 / Published: 14 January 2019
(This article belongs to the Section Pneumology and Respiratory Diseases)
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. View Full-Text
Keywords: pneumonia; ventilation; CPAP; NIV; BiLevel pneumonia; ventilation; CPAP; NIV; BiLevel
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MDPI and ACS Style

Vanoni, N.M.; Carugati, M.; Borsa, N.; Sotgiu, G.; Saderi, L.; Gori, A.; Mantero, M.; Aliberti, S.; Blasi, F. Management of Acute Respiratory Failure Due to Community-Acquired Pneumonia: A Systematic Review. Med. Sci. 2019, 7, 10. https://doi.org/10.3390/medsci7010010

AMA Style

Vanoni NM, Carugati M, Borsa N, Sotgiu G, Saderi L, Gori A, Mantero M, Aliberti S, Blasi F. Management of Acute Respiratory Failure Due to Community-Acquired Pneumonia: A Systematic Review. Medical Sciences. 2019; 7(1):10. https://doi.org/10.3390/medsci7010010

Chicago/Turabian Style

Vanoni, Nicolò Maria, Manuela Carugati, Noemi Borsa, Giovanni Sotgiu, Laura Saderi, Andrea Gori, Marco Mantero, Stefano Aliberti, and Francesco Blasi. 2019. "Management of Acute Respiratory Failure Due to Community-Acquired Pneumonia: A Systematic Review" Medical Sciences 7, no. 1: 10. https://doi.org/10.3390/medsci7010010

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