viernes, 11 de marzo de 2016

Neumonía / Pneumonia

Marzo 7, 2016. No. 2258


Manejo de la neumonía por Pseudomona aeuruginosa asociada al ventilador
Pseudomonas aeruginosa ventilator-associated pneumonia management.
Infect Drug Resist. 2016 Jan 20;9:7-18. doi: 10.2147/IDR.S50669. eCollection 2016.
Ventilator-associated pneumonia is the most common infection in intensive care unit patients associated with high morbidity rates and elevated economic costs; Pseudomonas aeruginosa is one of the most frequent bacteria linked with this entity, with a high attributable mortality despite adequate treatment that is increased in the presence of multiresistant strains, a situation that is becoming more common in intensive care units. In this manuscript, we review the current management of ventilator-associated pneumonia due to P. aeruginosa, the most recent antipseudomonal agents, and new adjunctive therapies that are shifting the way we treat these infections. We support early initiation of broad-spectrum antipseudomonal antibiotics in present, followed by culture-guided monotherapy de-escalation when susceptibilities are available. Future management should be directed at blocking virulence; the role of alternative strategies such as new antibiotics, nebulized treatments, and vaccines is promising.
KEYWORDS: ICU; adjunctive-therapies; care-bundles; multidrug-resistant; new-antibiotics
Valor pronóstico de procalcitonina en neumonía. Revisión sistemática y meta-análisis
Prognostic value of procalcitonin in pneumonia: A systematic review and meta-analysis.
Respirology. 2016 Feb;21(2):280-8. doi: 10.1111/resp.12704. Epub 2015 Dec 10.
For critically ill patients, an elevated PCT level was associated with an increased risk of mortality (RR 4.18, 95% CI: 3.19-5.48). The prognostic performance was nearly equal between patients with ventilator-associated pneumonia (VAP) and patients with CAP.
KEYWORDS: meta-analysis; mortality; pneumonia; procalcitonin; prognosis
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Anestesiología y Medicina del Dolor

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