Epidemiology

More than 300,000 cases of nosocomial pneumonia are reported each year with an associated mortality rate of 20-50%.' Risk factors for the development of pneumonia include subclinical aspiration of bacteria, trauma, surgical stress, underlying pulmonary dysfunction and exposure to hospital gram-negative organisms. Patients requiring tracheal intubation and ventilation have incidences of nosocomial pneumonia as high as 68%.

Naziri et al described clinical and immunologic alteration in patients with pneumonia. Their results found a mean time to onset from ICU admission was 5 days, the average temperature was 101.4°F, and a leukocytosis of 16,000 cells/mm3.2 The PaO2 was maintained > 100 at mean FiO2 of 0.47. Patients with poor outcomes had a greater temperature elevation and leukocytosis after 5 days of pneumonia.

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