Cases of pneumonia during the first 21/2 years of a respiratory-surgical intensive care unit (R-SICU) were analyzed. One hundred fifty-eight episodes of pneumonia were identified in 153 patients. Patients without pneumonia had a mortality of 3.8%. Patients admitted with or acquiring Gram-positive pneumonia did not have increased mortality. Patients who had Gram-negative pneumonias without involvement by Pseudomonas aeruginosa had a mortality of 33%. Isolation of Pseudomonas from respiratory cultures obtained from patients with pneumonia was associated with a mortality of 70%. Overall mortality of all patients admitted during the 30-month period was 13%. Eastablished Gram-negative Bacillus pneumonias are common, dangerous, and often not effectively treated. Environmental sources of Gram-negative pathogens should be reduced. Prophylactic regimens to prevent colonization of the respiratory tract may be helpful.
Rose Marie Stevens, Daniel Teres, John J. Skillman, David S. Feingold. Pneumonia in an Intensive Care UnitA 30-Month Experience. Arch Intern Med. 1974;134(1):106–111. doi:10.1001/archinte.1974.00320190108015