105 Host response in patients with ICU-acquired pneumonia • O2 saturation < 90% or PaO2 < 60 mmHg on room air if lower than baseline, or • A need to initiate or increase sustained (≥ 3 hours) supplemental oxygen to maintain preevent baseline O2 saturations Major criteria: A need to initiate non-invasive mechanical ventilation or re-initiate invasive mechanical ventilation because of respiratory failure or worsening of respiratory status Comorbidities Study definitions for the comorbidities at ICU admission Myocardial infarction History of medically documented myocardial infarction, not ECG changes only. Congestive heart failure Symptomatic congestive heart failure (exertional or paroxysmal nocturnal dyspnea) with response to specific treatment (digitalis, diuretics, or afterload reducing agents). Peripheral vascular disease Intermittent claudication, peripheral arterial bypass for insufficiency, gangrene, acute arterial insufficiency, untreated aneurysm (≥ 6 cm) Cerebrovascular accident History of transient ischaemic attack, or cerebrovascular accident with no or minor sequelae. Dementia Chronic cognitive deficit prior to this hospital admission. Chronic pulmonary disease Moderate: dyspnoeic with slight activity, with or without treatment, and dyspnoeic with moderate activity despite treatment. Severe: dyspnoeic at rest, despite treatment, requires constant oxygen; CO2 retention and a baseline PO2 below 50 torr. Connective tissue disease Diagnosis of either systemic lupus erythematosus, polymyositis, mixed connective tissue disease, polymyalgia rheumatica, moderate to severe rheumatoid arthritis. Peptic ulcer disease Patients who required prior treatment for peptic ulcer disease, including bleeding from ulcers. Renal disease Moderate: serum creatinine > 3 mg/dL (or >265μmol/L). Severe: on dialysis, had a transplant, and with uremia. Mild liver disease Cirrhosis without portal hypertension or chronic hepatitis. Moderate to severe liver disease Moderate: cirrhosis with portal hypertension, but without history of variceal bleeding. Severe: cirrhosis, portal hypertension, and a history of variceal bleeding. Diabetes without end-organ damage Mild: diabetes treated with insulin or oral hypoglycemics (not with diet alone). Moderate: includes if a subject had previous hospitalizations for ketoacidosis, hyperosmolar coma, or/and those with juvenile onset or brittle diabetics. Diabetes with endorgan damage Diabetes with either retinopathy, neuropathy, nephropathy. Hemiplegia Hemiplegia or paraplegia, as a result of either a cerebrovascular accident or other conditions. 5
RkJQdWJsaXNoZXIy MTk4NDMw