Critical Matters Management of pneumonia in the ICU
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Jun 26, 2025 Dr. Andre Kalil, a critical care physician and expert in infectious diseases, shares vital insights on managing pneumonia in critically ill patients. He emphasizes the importance of updated definitions for pneumonia types and the way these affect treatment strategies. Kalil discusses the role of tracheal aspirates over bronchoscopy in diagnosing ventilator-associated pneumonia. He highlights the significance of local antibiograms to tailor antibiotic choices and suggests cautious use of corticosteroids in severe cases. His practical tips can greatly enhance outcomes in the ICU.
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Pneumonia Is The ICU's Top Infectious Threat
- Pneumonia is the single most common infection causing ICU admission worldwide.
- It is also the leading cause of sepsis, so improving pneumonia care saves many lives.
Stop Using H-CAP To Justify Broad Antibiotics
- Do not use the obsolete 'healthcare-associated pneumonia' label to justify broad empiric antibiotics.
- Treat based on CAP, HAP, or VAP definitions and patient risk factors instead.
Use Clinical Assessment First, PCRs As Complement
- Do prioritize history, exam, and early radiology when diagnosing severe CAP; biomarkers can lag.
- Use PCR sputum/nasopharyngeal panels as complementary tools, not standalone answers.