The interrelations of radiologic findings and mechanical ventilation in community acquired pneumonia patients admitted to the intensive care unit: a multicentre retrospective study

Annals of Clinical Microbiology and Antimicrobials

Research

Hulya Turkan¹  Demet Tok²  Dilek Ozcengiz³  Unase Buyukkocak⁴  Ozgur Senturk⁵  Yakup Tomak⁶  Hafize Oksuz⁷  Sibel Temur⁸  Ozcan Erdemli⁹  Zeliha Kocak-Tufan^1,10  Gulden Yilmaz^1,11  Nefise Oztoprak^1,12  Hakan Erdem^1,13  Oral Oncul^1,13  Fatma Yilmaz-Karadag^1,14  Ahmet Karakas^1,15  Asuman Inan^1,16  Derya Ozturk-Engin^1,16  Hakan Leblebicioglu^1,17  Aygul Dogan-Celik^1,18  Canturk Taşcı^1,19  Hayati Bilgic^1,19  Aykut Cilli^2,20  Omer Yilmaz^2,21  Nalan Adıguzel^2,22  Ozlem Yazicioglu-Mocin^2,22  Gokay Gungor^2,22  Zuhal Karakurt^2,22 

[1] Department of Anesthesiology and Reanimation, Gulhane Medical Academy, Ankara, Turkey;Department of Anesthesiology and Reanimation, School of Medicine, Celal Bayar University, Manisa, Turkey;Department of Anesthesiology and Reanimation, School of Medicine, Cukurova University, Adana, Turkey;Department of Anesthesiology and Reanimation, School of Medicine, Kirikkale University, Kirikkale, Turkey;Department of Anesthesiology and Reanimation, School of Medicine, Maltepe University, Istanbul, Turkey;Department of Anesthesiology and Reanimation, School of Medicine, Sakarya University, Sakarya, Turkey;Department of Anesthesiology and Reanimation, School of Medicine, Sutcu Imam University, Kahramanmaras, Turkey;Department of Anesthesiology and Reanimation, School of Medicine, Yeditepe University, Istanbul, Turkey;Department of Anesthesiology and Reanimation, Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey;Department of Infectious Diseases and Clinical Microbiology, Ankara Atatürk Training & Research Hospital, Yildirim Beyazit University, Bilkent Ankara, Turkey;Department of Infectious Diseases and Clinical Microbiology, Ankara University School of Medicine, Ankara, Turkey;Department of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, Antalya, Turkey;Department of Infectious Diseases and Clinical Microbiology, GATA Haydarpasa Training Hospital, Istanbul, Turkey;Department of Infectious Diseases and Clinical Microbiology, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, Turkey;Department of Infectious Diseases and Clinical Microbiology, Gulhane Mecial Academy, Ankara, Turkey;Department of Infectious Diseases and Clinical Microbiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey;Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Ondokuz Mayis Iniveristy, Samsun, Turkey;Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Trakya University, Edirne, Turkey;Department of Pulmonary Diseases, Gulhane Medical Academy, Ankara, Turkey;Department of Pulmonary Diseases, School of Medicine, Antalya, Turkey;Department of Radiology, School of Medicine, Suleyman Demirel University, Isparta, Turkey;Sureyyapasa Chest Diseases and Thoracic Surgery Education and Research Hospital, Respiratory Intensive Care Unit, Istanbul, Turkey;

关键词: Radiography;    Thoracic;    Pneumoniae;    Imaging;    Critical care;   

DOI  :  10.1186/1476-0711-13-5

 received in 2013-07-24, accepted in 2014-01-06,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundWe evaluated patients admitted to the intensive care units with the diagnosis of community acquired pneumonia (CAP) regarding initial radiographic findings.MethodsA multicenter retrospective study was held. Chest x ray (CXR) and computerized tomography (CT) findings and also their associations with the need of ventilator support were evaluated.ResultsA total of 388 patients were enrolled. Consolidation was the main finding on CXR (89%) and CT (80%) examinations. Of all, 45% had multi-lobar involvement. Bilateral involvement was found in 40% and 44% on CXR and CT respectively. Abscesses and cavitations were rarely found. The highest correlation between CT and CXR findings was observed for interstitial involvement. More than 80% of patients needed ventilator support. Noninvasive mechanical ventilation (NIV) requirement was seen to be more common in those with multi-lobar involvement on CXR as 2.4-fold and consolidation on CT as 47-fold compared with those who do not have these findings. Invasive mechanical ventilation (IMV) need increased 8-fold in patients with multi-lobar involvement on CT.ConclusionCXR and CT findings correlate up to a limit in terms of interstitial involvement but not in high percentages in other findings. CAP patients who are admitted to the ICU are severe cases frequently requiring ventilator support. Initial CT and CXR findings may indicate the need for ventilator support, but the assumed ongoing real practice is important and the value of radiologic evaluation beyond clinical findings to predict the mechanical ventilation need is subject for further evaluation with large patient series.

【 授权许可】

Unknown   
© Erdem et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.