Challenges for a broad international implementation of the current severe community-acquired pneumonia guidelines

Jorge I F Salluh^{1

2}, Pedro Póvoa^{3

4

5}, Abi Beane^{6

7}, Andre Kalil⁸, Cornelius Sendagire⁹, Daniel A Sweeney¹⁰, David Pilcher^{11

12}, Eva Polverino¹³, Evelina Tacconelli¹⁴, Elisa Estenssoro¹⁵, Jean-Pierre Frat^{16

17}, Julio Ramirez^{18

19}, Luis Felipe Reyes^{20

21}, Oriol Roca^{22

23}, Saad Nseir^{24

25}, Vandack Nobre²⁶, Thiago Lisboa²⁷, Ignacio Martin-Loeches²⁸

Affiliations

¹ D'Or Institute for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil. jorgesalluh@gmail.com.
² Postgraduate Program of Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, UFRJ, Brazil. jorgesalluh@gmail.com.
³ NOVA Medical School, CHRC, New University of Lisbon, Lisbon, Portugal.
⁴ Research Unit of Clinical Epidemiology, Institute of Clinical Research, Odense University Hospital, University of Southern Denmark Centre for Clinical Epidemiology, Odense, Denmark.
⁵ Department of Intensive Care, Hospital de São Francisco Xavier, CHLO, Lisbon, Portugal.
⁶ Pandemic Science Hub and Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK.
⁷ NICS-MORU, Colombo, Sri Lanka.
⁸ Division of Infectious Diseases, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
⁹ Anesthesia and Critical Care, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
¹⁰ Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California, La Jolla, San Diego, CA, USA.
¹¹ Department of Intensive Care, Alfred Health, Commercial Road3004, Prahran, VIC, Australia.
¹² The Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcome and Resource Evaluation, Camberwell, Australia.
¹³ Pneumology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, CIBERES, Barcelona, Spain.
¹⁴ Division of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
¹⁵ Hospital Interzonal de Agudos General San Martín, Servicio de Terapia Intensiva, Buenos Aires, Argentina.
¹⁶ CHU de Poitiers, Médecine Intensive Réanimation, Poitiers, France.
¹⁷ INSERM, CIC-1402, IS-ALIVE, Faculté de Médecine Et de Pharmacie de Poitiers, Université de Poitiers, Poitiers, France.
¹⁸ Norton Infectious Diseases Institute, Norton Healthcare, Louisville, KY, USA.
¹⁹ University of Louisville, Louisville, KY, USA.
²⁰ Unisabana Center for Translational Science, School of Medicine, Universidad de La Sabana, Chia, Colombia.
²¹ Pandemic Sciences Institute, University of Oxford, Oxford, UK.
²² Servei de Medicina Intensiva, Parc Taulí Hospital Universitari, Institut de Recerca Part Taulí - I3PT, Parc del Taulí 1, 08028, Sabadell, Spain.
²³ Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain.
²⁴ Centre de Réanimation, CHU de Lille, 59000, Lille, France.
²⁵ Team Fungal Associated Invasive and Inflammatory Diseases, Lille Inflammation Research International Center, Université de Lille, INSERM U995, Lille, France.
²⁶ Department of Internal Medicine, Medical School and University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
²⁷ Critical Care Department, Programa de Pós-Graduação em Ciencias Pneumologicas, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
²⁸ Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization, St. James's University Hospital, Trinity Centre for Health Sciences, Dublin, Ireland.

PMID: 38546855
DOI: 10.1007/s00134-024-07381-z

Review

Challenges for a broad international implementation of the current severe community-acquired pneumonia guidelines

Jorge I F Salluh et al. Intensive Care Med. 2024 Apr.

. 2024 Apr;50(4):526-538.

doi: 10.1007/s00134-024-07381-z. Epub 2024 Mar 28.

Authors

Affiliations

¹ D'Or Institute for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil. jorgesalluh@gmail.com.
² Postgraduate Program of Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, UFRJ, Brazil. jorgesalluh@gmail.com.
³ NOVA Medical School, CHRC, New University of Lisbon, Lisbon, Portugal.
⁴ Research Unit of Clinical Epidemiology, Institute of Clinical Research, Odense University Hospital, University of Southern Denmark Centre for Clinical Epidemiology, Odense, Denmark.
⁵ Department of Intensive Care, Hospital de São Francisco Xavier, CHLO, Lisbon, Portugal.
⁶ Pandemic Science Hub and Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK.
⁷ NICS-MORU, Colombo, Sri Lanka.
⁸ Division of Infectious Diseases, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
⁹ Anesthesia and Critical Care, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
¹⁰ Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California, La Jolla, San Diego, CA, USA.
¹¹ Department of Intensive Care, Alfred Health, Commercial Road3004, Prahran, VIC, Australia.
¹² The Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcome and Resource Evaluation, Camberwell, Australia.
¹³ Pneumology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, CIBERES, Barcelona, Spain.
¹⁴ Division of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
¹⁵ Hospital Interzonal de Agudos General San Martín, Servicio de Terapia Intensiva, Buenos Aires, Argentina.
¹⁶ CHU de Poitiers, Médecine Intensive Réanimation, Poitiers, France.
¹⁷ INSERM, CIC-1402, IS-ALIVE, Faculté de Médecine Et de Pharmacie de Poitiers, Université de Poitiers, Poitiers, France.
¹⁸ Norton Infectious Diseases Institute, Norton Healthcare, Louisville, KY, USA.
¹⁹ University of Louisville, Louisville, KY, USA.
²⁰ Unisabana Center for Translational Science, School of Medicine, Universidad de La Sabana, Chia, Colombia.
²¹ Pandemic Sciences Institute, University of Oxford, Oxford, UK.
²² Servei de Medicina Intensiva, Parc Taulí Hospital Universitari, Institut de Recerca Part Taulí - I3PT, Parc del Taulí 1, 08028, Sabadell, Spain.
²³ Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain.
²⁴ Centre de Réanimation, CHU de Lille, 59000, Lille, France.
²⁵ Team Fungal Associated Invasive and Inflammatory Diseases, Lille Inflammation Research International Center, Université de Lille, INSERM U995, Lille, France.
²⁶ Department of Internal Medicine, Medical School and University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
²⁷ Critical Care Department, Programa de Pós-Graduação em Ciencias Pneumologicas, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
²⁸ Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization, St. James's University Hospital, Trinity Centre for Health Sciences, Dublin, Ireland.

PMID: 38546855
DOI: 10.1007/s00134-024-07381-z

Abstract

Severe community-acquired pneumonia (sCAP) remains one of the leading causes of admission to the intensive care unit, thus consuming a large share of resources and is associated with high mortality rates worldwide. The evidence generated by clinical studies in the last decade was translated into recommendations according to the first published guidelines focusing on severe community-acquired pneumonia. Despite the advances proposed by the present guidelines, several challenges preclude the prompt implementation of these diagnostic and therapeutic measures. The present article discusses the challenges for the broad implementation of the sCAP guidelines and proposes solutions when applicable.

Keywords: Acute respiratory failure; Guidelines; ICU; Lower respiratory tract infection; Sepsis; Severe community-acquired pneumonia.

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References

1. Troeger C, Blacker B, Khalil IA et al (2018) Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Infect Dis 18:1191–1210. https://doi.org/10.1016/S1473-3099(18)30310-4 - DOI
1. Martin-Loeches I, Torres A, Nagavci B et al (2023) ERS/ESICM/ESCMID/ALAT guidelines for the management of severe community-acquired pneumonia. Intensive Care Med 49:615–632. https://doi.org/10.1007/s00134-023-07033-8 - DOI - PubMed
1. Kerneis S, Visseaux B, Armand-Lefevre L, Timsit J-F (2021) Molecular diagnostic methods for pneumonia: how can they be applied in practice? Curr Opin Infect Dis 34:118–125. https://doi.org/10.1097/QCO.0000000000000713 - DOI - PubMed
1. Hanson KE, Azar MM, Banerjee R et al (2020) Molecular testing for acute respiratory tract infections: clinical and diagnostic recommendations from the IDSA’s diagnostics committee. Clin Infect Dis 71:2744–2751. https://doi.org/10.1093/cid/ciaa508 - DOI - PubMed
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Challenges for a broad international implementation of the current severe community-acquired pneumonia guidelines

Affiliations

Challenges for a broad international implementation of the current severe community-acquired pneumonia guidelines

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical