Which of the following would be associated with a fatal outcome in a patient with pneumonia who is mechanically ventilated?
a. Heart rate of 110 beats/min
b. Multisystem organ failure
c. Presence of purulent sputum
d. Respiratory alkalosis
ANS: B
In mechanically ventilated patients, factors associated with fatal outcome include the following:
? Infection with high-risk organisms such as P. aeruginosa, Acinetobacter species, and Steno-trophomonas maltophilia
? Multisystem organ failure
? Nonsurgical diagnosis
? Therapy with antacids or H2-receptor antagonists
? Transfer from another hospital or ward
? Renal failure
? Prolonged mechanical ventilation
? Coma or shock
? Inappropriate antibiotic therapy
? Hospitalization in a noncardiac ICU
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