Aerosol Therapy for Pneumonia in the Intensive Care Unit.

Charles-Edouard Luyt, Guillaume Hékimian, Nicolas Bréchot, Jean Chastre

Journal: Clinics in chest medicine 2019;39(4):823-836

PMID: 30390752

Full Text on Elsevier Science View on PubMed

Abstract

Antibiotic aerosolization in patients with ventilator-associated pneumonia (VAP) allows very high concentrations of antimicrobial agents in the respiratory secretions, far more than those achievable using the intravenous route. However, data in critically ill patients with pneumonia are limited. Administration of aerosolized antibiotics might increase the likelihood of clinical resolution, but no significant improvements in important outcomes have been consistently documented. Thus, aerosolized antibiotics should be restricted to the treatment of extensively resistant gram-negative pneumonia. In these cases, the use of a vibrating-mesh nebulizer seems to be more efficient, but specific settings and conditions are required to improve lung delivery.

Address: Service de Réanimation Médicale, Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, 47-83 Boulevard de l'Hôpital, Paris Cedex 13 75651, France.; Service de Réanimation Médicale, Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, 47-83 Boulevard de l'Hôpital, Paris Cedex 13 75651, France; Sorbonne Universités, UPMC Université Paris 06, INSERM, UMRS_1166-ICAN Institute of Cardiometabolism and Nutrition, Paris, France. Electronic address: [email protected].

DOI: 10.1016/j.ccm.2018.08.005

Link outs

Subscription / membership required

Full Text Sources:

MeSH Terms: Administration, Inhalation, Humans, Intensive Care Units, Pneumonia, Bacterial