الفهرس | Only 14 pages are availabe for public view |
Abstract Globally, Community-acquired pneumonia (CAP) remains among mortality’s leading causes and that defiantly require an immediate management regarding symptoms’ relief, determining the required level of management, providing anti-microbial therapy as early and appropriate as possible, preventing any further problems, and preventing any further respirational compromises. Both the CURB-65 score and the pneumonia severity index (PSI) are among the numerous scoring systems which are available for predicting the CAP’s severity and for identifying the required level of management. Also, chest X-ray and CT chest examinations are beneficial for CAP diagnosis. C-reactive protein, complete blood count, arterial blood gases, pro-calcitonin, and sputum culture are all useful laboratory markers for diagnosing and determining the severity of illness. Mechanical ventilation: either invasive or non-invasive is used for patients having life-threatening pneumonia that showed or developed respirational failure. This research’s goal was to evaluate the role of electrical cardiometry as an indicator for the invasive mechanical ventilation in the studied cases who presented CAP. This research is a prospective observational study that used 45 studied cases to be accomplished. These patients had a mean age between (64.87 ± 7.17) years and more males (53.3%). After the pneumonia diagnosis was confirmed by chest X-ray examination, the electrical cardiometry (EC) was attached to the patients in order to evaluate the thoracic fluid content (TFC) on admission and every 24 hours till discharged from ICU or required mechanical ventilation and we discovered that on admission at point (> 43 kΩ-1), TFC can be a valuable indicator for the mechanical ventilation needs. At the end of the research, participants were categorized into two groups; group I (n =22) was discharged from the ICU without need of mechanical ventilation, and group II (n =23) needed invasive mechanical ventilation. On admission, by plotting the ROC curve for the obtained TFC from EC (as an indicator of invasive mechanical ventilation in patient having CAP), the TFC on admission is considered a good indicator for the invasive mechanical ventilation (AUC= 0.766, 95% CI: 0.611 – 0.921, p ˂ 0.002) with cut of point > 43 kΩ-1, It had adequate results with sensitivity (82.61%) and specificity (86.36%) and an accuracy of 86.4%. Our obtained results showed that measuring TFC on admission has displayed an adequate specificity and sensitivity and it could be a valuable tool in managing the CAP studied cases. We recommend that a further larger multi-centric research should be conducted in order to investigate the TFC application as an indicator for invasive mechanical ventilation in the studied cases with CAP among other types of pneumonia. Also, we recommend that critical care clinicians must have training programs in or |