The pulmonary physician in critical care c 3: Critical care management of community acquired pneumonia

Community acquired pneumonia (CAP) is a common illness with an estimated incidence of 2–12 cases/1000 population per year. 2 The majority of cases of CAP are successfully managed outside hospital, but approximately 20% require hospital admission. Out of this group about 10% develop severe CAP and need treatment in an intensive care unit (ICU). The mortality of these patients can exceed 50%, and the purpose of this article is to review the management of severe CAP. Excellent guidelines for the management of CAP have been produced by several organisations including the British Thoracic Society (BTS), the American Thoracic Society (ATS), European and Infectious Disease Working Groups. Revised BTS guidelines have recently been published and previous ATS recommendations are being revised. Any practitioner who is responsible for patients with CAP should consult one of these documents. This article will discuss both general approaches to CAP and also highlight specific areas of critical care management.