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Aerosol Therapy for Pneumonia in the Intensive Care Unit

2018; Elsevier BV; Volume: 39; Issue: 4 Linguagem: Inglês

10.1016/j.ccm.2018.08.005

1557-8216

Charles‐Édouard Luyt, Guillaume Hékimian, Nicolas Bréchot, Jean Chastre,

Pneumonia and Respiratory Infections

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.