Critical Care

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Commentary

Can we predict septic shock in patients with hospital-acquired pneumonia?

Dylan W de Lange1 and Marc JM Bonten2*

Author Affiliations

1 Department of Intensive Care Medicine, and Department of Internal Medicine & Infectious Diseases, Division of General Medicine, Infectious Diseases & Geriatrics, University Medical Center Utrecht, Utrecht, The Netherlands

2 Department of Internal Medicine & Infectious Diseases, Division of General Medicine, Infectious Diseases & Geriatrics, Department of Medical Microbiology, Division of Hospital Hygiene & Infection Prevention, Julius Center for Health Care Epidemiology & Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands

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Critical Care 2005, 9:640-641 doi:10.1186/cc3919

Published: 11 November 2005

Abstract

Hospital-acquired pneumonia is a serious and potentially life-threatening complication, with reported pneumonia-attributable mortality rates as high as 50%. Rapid diagnosis and immediate institution of adequate empirical antimicrobial treatment are of paramount importance in patient management. Nevertheless, some patients deteriorate and develop respiratory insufficiency, septic shock and a multiorgan dysfunction syndrome. Early recognition of these patients might help in reducing morbidity and mortality. Elevated systemic levels of proinflammatory cytokines (IL-1β, IL-6, IL-8 and IL-10) at the time of diagnosis of hospital-acquired pneumonia appear to be indicative of subsequent progression to septic shock. Should this now become a part of patient management?