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J Infect. 2015 Jun;70(6):553-62. doi: 10.1016/j.jinf.2015.01.012. Epub 2015 Jan 31.

Early-onset pneumonia after out-of-hospital cardiac arrest.

Author information

1
Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece; Pulmonary Department, Evangelismos, General Hospital of Athens, Greece. Electronic address: sotikaka@yahoo.com.
2
Université Paris Est, Faculté de Médecine, Service d'Anesthésie et des Réanimations Chirurgicales, Hôpitaux Universitaires Henri Mondor, Assistance Publique des Hôpitaux de Paris, Créteil, France; Service d'Anesthésie et des Réanimations Chirurgicales, Hôpitaux Universitaires Henri Mondor, Assistance Publique des Hôpitaux de Paris, Université Paris Est, Faculté de Médecine, INSERM U955, Equipe 3, physiopathologie et pharmacologie des insuffisances coronaires et cardiaques, Créteil, France. Electronic address: nicolas.mongardon@hmn.aphp.fr.
3
Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Service de Réanimation Médicale, Hôpital Cochin, Hôpitaux Universitaires Paris Centre, Assistance Publique des Hôpitaux de Paris, Paris, France; Service de Réanimation Médicale, Hôpital Cochin, Hôpitaux Universitaires Paris Centre, Assistance Publique des Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine; INSERM U970, Paris Cardiovascular Research Centre (PARCC), European Georges Pompidou Hospital, Paris, France. Electronic address: alain.cariou@cch.aphp.fr.
4
Midwestern University, Downers Grove, IL, USA. Electronic address: dr.anil.gulati@gmail.com.
5
Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece; Midwestern University, Downers Grove, IL, USA. Electronic address: theodorosxanthos@yahoo.com.

Abstract

Early-onset pneumonia (EOP) is a common complication after successful cardiopulmonary resuscitation. Currently, EOP diagnosis is difficult because usual diagnostic tools are blunted by the features of post-cardiac arrest syndrome and therapeutic hypothermia itself. When the diagnosis of EOP is suspected, empiric antimicrobial therapy should be considered following bronchopulmonary sampling. The onset of EOP increases the length of mechanical ventilation duration and intensive care unit stay, but its influence on survival and neurological outcome seems marginal. Therapeutic hypothermia has been recognized as an independent risk factor for this infectious complication. All together, these observations underline the need for future prospective clinical trials to better delineate pathogens and risk factors associated with EOP. In addition, there is a need for diagnostic approaches serving the accurate diagnosis of EOP.

KEYWORDS:

Aspiration; Out-of-hospital cardiac arrest; Pneumonia; Resuscitation; Therapeutic hypothermia

PMID:
25644317
DOI:
10.1016/j.jinf.2015.01.012
[Indexed for MEDLINE]

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