Severe pneumonia
Conditions
Interventions
Control group:According to the current diagnosis and treatment of severe pneumonia routine
Experimental group:Lung protective ventilation and prone ventilation were used in advance to treat ARDS patients whose probability of progression to ARDS was more than 50% predicted by the model.
Sponsors
The Second Affiliated Hospital of Zunyi Medical University
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: CAP inclusion criteria: Meet the 2007 Infectious Diseases Society of America/American Thoracic Society (ATS/ IDSA) Consensus Guidelines for CAP management in adults: Main criteria: 1. Invasive mechanical ventilation; 2. Septic shock requiring vasopressors; Secondary criteria: 1. respiratory rate =30 times/min; 2.PaO2/FiO2 =250mmHg; 3. Multiple lung lobe infiltration; 4. Blurred consciousness or disorientation; 5. uremia (blood urea nitrogen level =20mg/dl); 6. leukopenia (white blood cell count 38?); 2. leukocyte increase > 12×10^9/L or decrease < 4×10^9/L; 3. Purulent airway secretions; According to the Chinese Guidelines for the Diagnosis and Treatment of hospital-acquired pneumonia and ventilator-associated Pneumonia (2018 edition), it is considered that :1. Mechanical ventilation therapy with tracheal intubation is required; 2. Septic shock that still requires vasoactive drug therapy after active fluid resuscitation; Those who meet either of these criteria are diagnosed with severe HAP.
Exclusion criteria
Exclusion criteria: Exclusion criteria for CAP: 1. Patients with severe respiratory dysfunction, such as ARDS, acute respiratory failure, and severe pulmonary edema, had been diagnosed before the onset of CAP. 2. Long-term oxygen therapy is required after multiple (> 2) hospital admissions due to pneumonia or tracheotomy; 3. Transferred from other departments to comprehensive ICU or respiratory department during hospitalization; 4. Combined with other risk factors at admission; 5. Hospital stay 2) hospital admissions due to pneumonia or tracheotomy; 4. Transferred from other departments to comprehensive ICU or respiratory department during hospitalization; 5. Duration of hospitalization <48h; 6. the clinical data is not perfect; 7. age < 18 years or =80 years old.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| In-hospital mortality rate; | — |
Secondary
| Measure | Time frame |
|---|---|
| Ventilator use time during hospitalization;Hospitalization expenses;Hospital stay; | — |
Countries
china
Contacts
Public ContactGuiyang Jia
The Second Affiliated Hospital of Zunyi Medical University
Outcome results
None listed