Community-acquired Pneumonia in Critically Ill Very Old Patients: a Growing Problem

Overview

Journal Eur Respir Rev

Specialty Pulmonary Medicine

Date 2020 Feb 21

PMID 32075858

Citations 27

Authors

Catia Cilloniz

Cristina Dominedo

Juan M Pericas

Diana Rodriguez-Hurtado

Antoni Torres

Affiliations

Soon will be listed here.

Abstract

Very old (aged ≥80 years) adults constitute an increasing proportion of the global population. Currently, this subgroup of patients represents an important percentage of patients admitted to the intensive care unit. Community-acquired pneumonia (CAP) frequently affects very old adults. However, there are no specific recommendations for the management of critically ill very old CAP patients. Multiple morbidities, polypharmacy, immunosenescence and frailty contribute to an increased risk of pneumonia in this population. CAP in critically ill very old patients is associated with higher short- and long-term mortality; however, because of its uncommon presentation, diagnosis can be very difficult. Management of critically ill very old CAP patients should be guided by their baseline characteristics, clinical presentation and risk factors for multidrug-resistant pathogens. Hospitalisation in intermediate care may be a good option for critical ill very old CAP patients who do not require invasive procedures and for whom intensive care is questionable in terms of benefit.

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