Severe community-acquired pneumonia and PIRO: a new paradigm of management.
Appropriate antibiotic management and aggressive supportive therapy is not enough to improve survival in severe community-acquired pneumonia (sCAP), a systemic syndrome involving infectious organisms, inflammation, and coagulation systems. A sepsis severity staging system focused on predisposition, insult, deleterious response, and organ failure (PIRO) provides a useful basis for risk stratification and therapy. A new paradigm of management is suggested based on early identification of patients at risk, aggressive management, modulation of host response, and need for adjunctive therapy. The CAP-PIRO score is a new, simple tool stratifying patients in four categories and may be useful for early identification of patients who may benefit from adjunctive therapy.
Rello
Jordi
J
Joan XXIII University Hospital, Carrer Mallafre Guasch 4, 43007 Tarragona, Spain. Jrello.hj23.ics@gencat.cat
Lisboa
Thiago
T
Wunderink
Richard
R
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