Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- dyspnea
- productive cough
- fever
Otros factores de diagnóstico
- chest pain
- asymmetric expansion of the chest
- diminished resonance
- egophony
- whisper pectoriloquy
- crackles or rhonchi
- tachycardia
- malaise/anorexia
Factores de riesgo
- poor infection control/hand hygiene
- intubation and mechanical ventilation; endotracheal cuff pressure <20 cm H₂O
- supine position
- poor oral hygiene
- sedation/no interruption in sedation
- intubation/reintubation
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- chest x-ray
- WBC count with differential
- pulse oximetry
- culture of lower respiratory tract sample
Pruebas diagnósticas que deben considerarse
- ABG
- diagnostic thoracentesis
- CT chest
- CRP
- lung ultrasound
Pruebas emergentes
- MRSA nasal swab
Algoritmo de tratamiento
before culture results: without risk factors for multidrug-resistant (MDR) pathogen
before culture results: with risk factors for multidrug-resistant (MDR) pathogen, including Pseudomonas and MRSA
after culture results: due to gram-negative pathogen
after culture results: due to gram-positive pathogen
Colaboradores
Consejeros especializados
Forest W. Arnold, DO, MSc, FIDSA
Professor of Medicine
Chief, Division of Infectious Diseases
Director Infectious Diseases Fellowship Training Program
Department of Medicine
School of Medicine
University of Louisville
Louisville
KY
Divulgaciones
FWA declares that he has no competing interests.
Revisores por pares
Krishna Sundar, MD, FCCP
Associate Professor (Clinical)
Department of Medicine
University of Utah
Director
Pulmonary and Critical Care Research
IHC Urban South
Utah Valley Pulmonary Clinic
UT
Divulgaciones
KS declares that he has no competing interests.
Ozan Akca, MD
Director of Research
Associate Professor
Department of Anesthesiology and Perioperative Medicine
Neuroscience and Anesthesia Intensive Care Unit
University of Louisville
Louisville
KY
Divulgaciones
OA declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referencias
Artículos principales
Kalil AC, Metersky ML, Klompas M, et al. Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis. 2016 Sep 1;63(5):e61-111.Texto completo Resumen
Klompas M, Branson R, Cawcutt K, et al. Strategies to prevent ventilator-associated pneumonia, ventilator-associated events, and nonventilator hospital-acquired pneumonia in acute-care hospitals: 2022 Update. Infect Control Hosp Epidemiol. 2022 Jun;43(6):687-713.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Coronavirus disease 2019 (COVID-19)
- Cardiogenic pulmonary edema
- Acute respiratory distress syndrome
Más DiferencialesGuías de práctica clínica
- Strategies to prevent ventilator-associated pneumonia, ventilator-associated events, and nonventilator hospital-acquired pneumonia in acute-care hospitals
- Management of adults with hospital-acquired and ventilator-associated pneumonia
Más Guías de práctica clínicaVideos
Supraglottic airway devices: animated demonstration
Nasopharyngeal airway: animated demonstration
Más vídeosFolletos para el paciente
Pneumonia
Más Folletos para el pacienteInicie sesión o suscríbase para acceder a todo el BMJ Best Practice
El uso de este contenido está sujeto a nuestra cláusula de exención de responsabilidad