The Internet Book of Critical Care Podcast IBCC Episode 4 - Community Onset Pneumonia
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Sep 26, 2018 This podcast discusses the approach and management of community onset pneumonia, including diagnostic tests, antibiotic treatment, use of high-flow nasal cannula, timing of intubation, steroid use in pneumonia, and management of pleural effusions.
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Community Onset Pneumonia Concept
- The concept of healthcare-associated pneumonia (H-CAP) has largely been abandoned in guidelines due to lack of evidence.
- The term "community onset pneumonia" better captures pneumonia occurring at hospital admission, including community and healthcare-associated cases.
Complex Diagnosis of Pneumonia
- Diagnosing pneumonia is complex due to diverse presentations and multiple potential mimics.
- Diagnosis requires integrating imaging, systemic inflammation signs, and pulmonary symptoms carefully.
Key Pneumonia Diagnostic Tests
- Obtain blood cultures, sputum cultures, and urine antigens routinely, though yield is low.
- Use procalcitonin to help guide diagnosis and consider viral PCR for cohorting, but be cautious stopping antibiotics based on viral results alone.