Bacterial pneumonia secondary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz, M.B.B.S
Overview
Secondary prevention occurs once the disease has occurred and aims to prevent progression and complication development. Protective measures include controlling the tidal volume, plateau pressure, PEEP, and FiO2. Measures taken to reduce the risk of aspiration such as elevation of the head end of bed and maintaining oral hygiene also help preventing aspiration pneumonia. Common complications that can develop due to bacterial pneumonia include acute respiratory distress, pleural effusion, heart failure due to pneumonia, sepsis, and septic shock.
Prevention of Complications
As lung-related complications are more prevalent, many protective mechanisms have been developed and integrated to prevent injury:[1]
- Tidal volume between 6 and 8 mL/kg of body weight
- Plateau pressure < 30 cm H2O
- PEEP ≥ 5 cm H2O
- Minimize FiO2 (levels >60% lead are associated with oxygen toxicity)
- Reduce the risk of aspiration (elevate head end of bed, maintain oral hygiene)
Sepsis and septic shock are prevented by the timely use of appropriate antibiotics, aggressive fluid resuscitation[2] along with the use of vasopressors if required.
References
- ↑ Beitler JR, Schoenfeld DA, Thompson BT (2014). "Preventing ARDS: progress, promise, and pitfalls". Chest. 146 (4): 1102–1113. doi:10.1378/chest.14-0555. PMC 4188145. PMID 25288000.
- ↑ Rivers EP, Jaehne AK, Eichhorn-Wharry L, Brown S, Amponsah D (2010). "Fluid therapy in septic shock". Curr Opin Crit Care. 16 (4): 297–308. doi:10.1097/MCC.0b013e32833be8b3. PMID 20601867.