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Pneumonia patients at risk for in-hospital cardiac arrest
Date:5/15/2011

ere appears to be an important group of patients with pneumonia who develop cardiac arrest without respiratory failure or shock."

This is the first large study to report the characteristics of in-hospital cardiopulmonary arrest among patients with pneumonia. The finding that many of these patients are not receiving intensive care or interventions suggests that patients with pneumonia are either more vulnerable than previously thought to abrupt deterioration or that the triage methods used to determine whether a patient is in need of intensive care may be inadequate for patients with pneumonia.

"Decisions about ICU admission may need to be more proactive rather than reactive," Dr. Carr noted. "If we focus our intensive care resources on patients with obvious shock and respiratory failure, we may miss opportunities to intervene on other patients who are at high risk for abrupt deterioration.

"Future studies should investigate the incidence and causes of sudden, early cardiovascular collapse in patients with pneumonia and other forms of sepsis, and address ways to measure and mitigate this risk," he continued. "In the meantime, physicians need to be alert to the possibility of abrupt transitions in these patients."

Finally, Dr. Carr suggested that these findings indicate a need for more research on the different phenotypes of sepsis, of which pneumonia is a major cause. "In recent years we have been lumping these patients into one big group, to facilitate research and the dissemination of care 'bundles'," he said. "In clinical reality, pneumonia and sepsis may be very heterogeneous, and patients who die from these diseases may follow different trajectories. Accordingly, we may need different risk assessment and therapeutic tools for different subgroups."


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Contact: Keely Savoie
ksavoie@thoracic.org
212-315-8620
American Thoracic Society
Source:Eurekalert

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