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Báo cáo y học: "ICU admission and severity assessment in community-acquired pneumonia"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: ICU admission and severity assessment in community-acquired pneumonia. | Available online http ccforum.eom content 13 3 156 Commentary ICU admission and severity assessment in community-acquired pneumonia James D Chalmers Queens Medical Research Institute Centre for Inflammation Research Little France Edinburgh EH16 4TJ UK Corresponding author James D Chalmers jamesdchalmers@googlemail.com Published 15 June 2009 This article is online at http ccforum.com content 13 3 156 2009 BioMed Central Ltd Critical Care 2009 13 156 doi 10.1186 cc7889 See related research by Renaud et al. http ccforum.com content 13 2 R54 Abstract The past 15 years have seen major advances in our understanding of severity assessment in community-acquired pneumonia CAP . Prognostic tools have been promoted to guide all major management decisions in CAP including admission to the critical care unit. Several recent studies including the study by Renaud and colleagues have challenged us to re-evaluate how we consider severe CAP a concept for which there is still no universally accepted definition. Existing severity scores such as the Pneumonia Severity Index and the CURB65 score are designed to predict 30-day mortality. As a result they are heavily weighted by age and co-morbidity. They perform less well when predicting other outcomes such as requirement for ICU admission and are of limited use in the critical care environment. This commentary discusses recent attempts to develop useful severity criteria to guide the use of ICU resources in patients with severe CAP. The past 15 years have seen major advances in our understanding of severity assessment in community-acquired pneumonia CAP . Prognostic tools have been promoted to guide all major management decisions in CAP including admission to the critical care unit. Several recent studies including the study by Renaud and colleagues 1 have challenged us to re-evaluate how we consider severe CAP a concept for which there is still no universally accepted definition. Since the development of the Pneumonia Severity Index in