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Pathophysiology of Pneumonia and the Clinical Consequences

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Community-Acquired Pneumonia
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References

  • Adams, D. H., & Shaw, S. (1994). Leucocyte-endothelial interactions and regulation of leucocyte migration. Lancet, 343, 831–836.

    Article  PubMed  CAS  Google Scholar 

  • American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference. (1992). Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit. Care Med., 20, 864–874.

    Google Scholar 

  • Archer, S. L., Tolins, J. P., Raij, L., & Weir, E. K. (1989). Hypoxic pulmonary vasoconstriction is enhanced by inhibition of the synthesis of an endothelium-derived relaxing factor. Biochem. Biophys. Res. Commun., 164, 1198–1205.

    Article  PubMed  CAS  Google Scholar 

  • Astiz, M. E., & Rackow, E. C. (1998). Septic shock. Lancet, 351, 1501–1505.

    Article  PubMed  CAS  Google Scholar 

  • Baggiolini, M., Walz, A., & Kunkel, S. L. (1989). Neutrophil-activating peptide-1/interleukin 8, a novel cytokine that activates neutrophils. J. Clin. Invest., 84, 1045–1049.

    Article  PubMed  CAS  Google Scholar 

  • Berk, S. A., Holtsclaw, S. A., Kahn, A., & Smith, J. K. (1981). Transtracheal aspiration of the severely ill elderly patient with bacterial pneumonia. J. Am. Geriatr. Soc., 29, 228–231.

    PubMed  CAS  Google Scholar 

  • Bernstein, J.M. (1999). Treatment of community-acquired pneumonia—IDSA guidelines. Infectious Diseases Society of America. Chest, 115, 9S–13S.

    Article  PubMed  CAS  Google Scholar 

  • Beutler, B., Krochin, N., Milsark, I. W., Luedke, C., & Cerami, A. (1986). Control of cachectin (tumor necrosis factor) synthesis: mechanisms of endotoxin resistance. Science, 232, 977–980.

    Article  PubMed  CAS  Google Scholar 

  • Binger, C. A. L., & Brow, G. R. (1924). Studies on the respiratory mechanism in lobar pneumonia. J. Exp. Med., 39, 677–705.

    Article  CAS  PubMed  Google Scholar 

  • Bone, R. C. (1992). The pathogenesis of sepsis. Ann. Intern. Med., 115, 457–469.

    Google Scholar 

  • Bone, R. C. (1996). Immunologic dissonance: a continuing evolution in our understanding of the systemic inflammatory response syndrome (SIRS) and the multiple organ dysfunction syndrome (MODS). Ann. Intern. Med., 125, 60–87.

    Google Scholar 

  • Bone, R. C., Balk, R. A., Cerra, F. B., Dellinger, R. P., Fein, A. M., Knaus, W. A., Schein, R. M, & Sibbald, W. J. (1992). Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 101, 1644–1655.

    Article  PubMed  CAS  Google Scholar 

  • Camner, P. (1980). Clearance of particles from the human tracheobronchial tree. Clin. Sci., 59, 79–84.

    PubMed  CAS  Google Scholar 

  • Chapman, K. R., D’Urzo, A., & Rebuck, A. S. (1983). The accuracy and response characteristics of a simplified ear oximeter. Chest, 83, 860–864.

    Article  PubMed  CAS  Google Scholar 

  • Colp, C. R., Park, S. S., & Williams, M. H. (1962). Pulmonary function studies in pneumonia. Am. Rev. Respir. Dis., 85, 808–815.

    Google Scholar 

  • Coonrod, J. D. (1986). The role of extracellular bactericidal factors in pulmonary host defense. Semin. Respir. Infect., I, 118–129.

    Google Scholar 

  • Curley, F. J., & Smyrnios, N. A. (1991). Routine monitoring in critically ill patients, in Intensive Care Medicine, 2nd ed. (J. M. Rippe, R. S. Irwin, J. S. Alpert, & M. P. Fink, eds.). Boston, Toronto, London: Little, Brown and Company, pp. 199–214.

    Google Scholar 

  • De Waal-Malefyt, R., Abrams, J., Bennett, B., Figdor, C. G., & DeVries, J. E. (1991). 11–10 inhibits cytokine synthesis by human monocytes. J. Exp. Med., 174, 1209–1220.

    Article  PubMed  Google Scholar 

  • Desmecht, D. J., Linden, A. S., & Lekeux, P. M. (1996). The relation of ventilatory failure to pulmonary, respiratory muscle and central nervous system disturbances in calves with an experimentally produced pneumonia. J. Comp. Pathoi, 115, 203–219.

    Article  CAS  Google Scholar 

  • Ellison, R., & Giehl, T. (1991). Killing of gram-negative bacteria by lactoferrin and lysozyme. J. Clin. Invest., 88, 1080–1091.

    Article  PubMed  CAS  Google Scholar 

  • Ellison, R., Giehl, T., & Laforce, F. (1988). Damage to the outer membrane of enteric gram-negative bacteria by lactoferrin and transferrin. Infect. Immun., 56, 2774–2781.

    PubMed  CAS  Google Scholar 

  • Fine, M. J., Auble, T. E., Yealy, D. M., Hanusa, B. H., Weissfeld, L. A., Singer, D. E., Coley, C. M., Marrie, T. J., & Kapoor, W. N. (1997). A prediction rule to identify low-risk patients with community-acquired pneumonia. N. Engl. J. Med., 336, 243–250.

    Article  PubMed  CAS  Google Scholar 

  • Finkelstein, P. A., Sciortino, C. V., & McIntosh, M. A. (1983). The role of iron in microbe-host interactions. Rev. infect. Dis., 5(Suppl.), S759–S777.

    PubMed  Google Scholar 

  • Flick, M. R., & Block, A. J. (1977). Continuous in vivo measurement of arterial oxygen saturation by oximetry. Heart Lung, 6, 990–993.

    PubMed  CAS  Google Scholar 

  • Gea, J., Roca, J., Torres, A., Agusti, A. G., Wagner, P. D., & Rodriguez-Roisin, R. (1991). Mechanisms of abnormal gas exchange in patients with pneumonia. Anesthesiology, 75, 782–789.

    Article  PubMed  CAS  Google Scholar 

  • Geerdes, H. F., Ziegler, D., Lode, H., Hund, M., Loehr, A., Fangmann, W., Wagner, J. (1992). Septicemia in 980 patients at a university hospital in Berlin: prospective studies during 4 selected years between 1979 and 1989. Clin. Infect. Dis., 15, 991–1002.

    PubMed  CAS  Google Scholar 

  • Goldzimmer, E. L., Konopka, R. G., & Moser K. M. (1974). Reversal of the perfusion defect in experimental canine lobar pneumonia. J. Appl. Physiol., 37, 85–91.

    Google Scholar 

  • Green, G. M., Jakab, G. J., Low, R. B., & Davis, G. S. (1977). Defense mechanisms of the respiratory membrane. Am. Rev. Respir. Dis., 15, 479–515.

    Google Scholar 

  • Hall, J. B., Schmidt, G. A., & Wood, L. D. H. (1992). Principles of Critical Care, 1st ed. New York, St. Louis, San Francisco: McGraw-Hill Inc.

    Google Scholar 

  • Hanley, P., & Light, R. B. (1987). Lung mechanics, gas exchange, pulmonary perfusion and hemodynamics in a canine model of acute Pseudomonas pneumonia. Lung, 165, 305–322.

    Article  Google Scholar 

  • Horn, K. D. (1998). Evolving strategies in the treatment of sepsis and systemic inflammatory response syndrome (SIRS). Quart. J. Med., 91, 265–277.

    CAS  Google Scholar 

  • Hussain, S. N. (1998). Respiratory muscle dysfunction in sepsis. Mol. Cell. Biochem., 179, 125–134.

    Article  PubMed  CAS  Google Scholar 

  • Huxley, E. J., Viroslav, J., Gray, W. R., & Pierce, A. K. (1978). Pharyngeal aspiration in normal adults and patients with depressed consciousness. Am. J. Med., 64, 564–568.

    Article  PubMed  CAS  Google Scholar 

  • Johanson, W. G., Pierce, A. K., & Sanford, J. P. (1969). Changing pharyngeal flora of hospitalized patients: Emergence of gram-negative bacilli. N. Engl. J. Med., 281, 1137–1140.

    Article  PubMed  CAS  Google Scholar 

  • Johanson, W. G. Jr., Pierce, A. K., Sanford, J. P., & Thomas, G. D. (1972). Nosocomial respiratory infections with gram negative bacilli: the significance of colonization of the respiratory tract. Ann. Intern. Med., 77, 701–706.

    PubMed  Google Scholar 

  • Kato, M., & Staub, J. F. (1966). Response of small pulmonary arteries to unilobar hypoxia and hypercapnea. Circ. Res., 19, 426.

    PubMed  CAS  Google Scholar 

  • Klebanoff, S. J., Vadas, M. A., Harlan, J. M., Sparkes, L. H., Gamble, J. R., Agosti, J. M., & Waltersdorph, A. M. (1986). Stimulation of neutrophils by tumor necrosis factor. J. Immunol, 136, 4220–4225.

    PubMed  CAS  Google Scholar 

  • Klosterhalfen, B., & Bhardwaj, R. S. (1998). Septic shock. Gen. Pharmacol., 31, 25–32.

    Article  PubMed  CAS  Google Scholar 

  • LaForce, F. M., Hopkins, J., Trow, R., & Wang. W. L. (1976). Human oral defenses against gram-negative rods. Am. Rev. Respir. Dis., 148, 929–935.

    Google Scholar 

  • Lampron, N., Lemaire, F, Teisseire, B., Harf, A., Palot, M., Matamis, D., & Lorino, A. M. (1985). Mechanical ventilation with 100% oxygen does not increase intrapulmonary shunt in patients with severe bacterial pneumonia. Am. Rev. Respir. Dis., 131, 409–413.

    PubMed  CAS  Google Scholar 

  • Light, R. B. (1986). Indomethacin and acetylsalicylic acid reduce intrapulmonary shunt in experimental pneumococcal pneumonia. Am. Rev. Respir. Dis., 134, 520–525.

    PubMed  CAS  Google Scholar 

  • Light, R. B. (1992). Septic shock, in: Principles of Critical Care, 1st ed. (J. B. Hall, G. A. Schmidt, & L. D. H. Wood, eds.) New York, St. Louis, San Francisco: McGraw-Hill Inc.

    Google Scholar 

  • Lipscomb, M. F., Onofrio, J. M., Nash, E. J., Pierce, A. K., & Toews, G. B. (1983). A morphological study of the role of phagocytes in the clearance of Staphylococcus aureus from the lung. J. Reticuloendothel. Soc., 33, 429–442.

    PubMed  CAS  Google Scholar 

  • Mackowiak, P. A. (1982). The normal microbial flora. N. Engl. J. Med., 307, 83–93.

    Article  PubMed  CAS  Google Scholar 

  • MacNee, W. & Selby, C. (1990). Neutrophil kinetics in the lungs. Clin. Sci., 79, 97–107.

    PubMed  CAS  Google Scholar 

  • Mandell, L. A., & Neiderman, M. (1993). The Canadian Community Acquired Pneumonia Consensus Conference Group. Antimicrobial treatment of community acquired pneumonia in adults: a conference report. Can. J. Infect. Dis., 4, 25–28.

    Google Scholar 

  • Marrie, T. J. (1992). Pneumonia. Clin. Geriatr. Med., 8, 721–734.

    PubMed  CAS  Google Scholar 

  • Marrie, T. J. (1994). Community acquired pneumonia. Clin. Infect. Dis., 18, 501–515.

    PubMed  CAS  Google Scholar 

  • Marrie, T. J., Durant, H., & Yates, L. (1989). Community acquired pneumonia requiring hospitalization: 5 year prospective study. Rev. Infect. Dis., 11, 586–599.

    PubMed  CAS  Google Scholar 

  • Marshall, R., & Christie, R. V. (1954). The visco-elastic properties of the lungs in acute pneumonia. Clin. Sci., 13, 403–408.

    PubMed  CAS  Google Scholar 

  • Masson, P. L., Heremans, J. F, Prignot, J. J., & Wauters, G. (1966). Immunohistochemical localization and bacteriostatic properties of an iron-binding protein from bronchial mucus. Thorax, 21, 538–544.

    Article  PubMed  CAS  Google Scholar 

  • McCormack, D. G., & Paterson, N. A. (1993). Loss of hypoxic pulmonary vasoconstriction in chronic pneumonia is not mediated by nitric oxide. Am. J. Physiol., 265, HI523–HI528.

    Google Scholar 

  • Mink, S. N., Light, R. B., & Wood, L. D. H. (1981). Effect of pneumococcal lobar pneumonia on canine lung mechanics. J. Appl. Physiol.: Respirat. Environ. Exercise Physiol., 50, 283–291.

    CAS  Google Scholar 

  • Murphy, K., Haudek, S. B., Thompson, M., & Giroir, B. P. (1998). Molecular biology of septic shock. New Horiz., 6, 181–193.

    PubMed  CAS  Google Scholar 

  • Murray, J. F. (1986). The Normal Lung, 2nd ed. Philadelphia: W.B. Saunders.

    Google Scholar 

  • Neiderman, M. S., Merrill, W. W., Polomski, L. M., Reynolds, H. Y, & Gee, J. B. (1986). Influence of sputum IgA and elastase on tracheal cell bacterial adherence. Am. Rev. Respir. Dis., 133, 255–260.

    Google Scholar 

  • Neiderman, M. S., Bass, J. B., Campbell, G. D., Fein, A. M., Grossman, R. F., Mandell, L. A., Marrie, T. J., Sarosi, G. A., Torres, A., & Yu, V. L. (1993). Guidelines for the initial empiric therapy of community acquired pneumonia: proceedings of an American Thoracic Society Consensus Conference. Am. Rev. Respir. Dis., 148, 1418–1426.

    Google Scholar 

  • Nelson, S., Mason, C. M., Kolls, J., & Summer, W. (1995). Pathophysiology of pneumonia. Clin. Chest Med., 16, 1–12.

    PubMed  CAS  Google Scholar 

  • Parker, M. M. (1998). Pathophysiology of cardiovascular dysfunction in septic shock. New Horiz., 6, 130–138.

    PubMed  CAS  Google Scholar 

  • Parsons, P. E., Moss, M., Vannice, J. L., Moore, E. E., Moore, F. A., & Repine, J. E. (1997). Circulating Il-lra and 11–10 levels are increased but do not predict the development of acute respiratory distress syndrome in at-risk patients. Am. J. Respir. Crit. Care Med., 155, 1469–1473.

    PubMed  CAS  Google Scholar 

  • Persson, M. G., Gustafsson, L. E., Wiklund, N. P., Moncada, S., & Hedqvist, P. Endogenous nitric oxide as a probable modulator of pulmonary circulation and hypoxic pressor response in vivo. Acta Physiol. Scand., 140, 449–457.

    Google Scholar 

  • Piper, R. D. (1998). Myocardial dysfunction in sepsis. Clin. Exp. Pharmacol. Physiol., 25, 951–954.

    Article  PubMed  CAS  Google Scholar 

  • Ries, A. L., Farrow, J. T., & Claussen, J. L. (1985). Accuracy of two oximeters at rest and during exercise in pulmonary patients. Am. Rev. Respir. Dis., 32, 685–689.

    Google Scholar 

  • Rodriguez-Roisin, R., & Roca, J. (1996). Update’ 96 on pulmonary gas exchange pathophysiology in pneumonia. Semin. Respir. Infect., 11, 3–12.

    PubMed  CAS  Google Scholar 

  • Sariban, E., Imamura, K., Luebbers, R., Kufe, D. (1988). Transcriptional and posttranscriptional regulation of tumor necrosis factor gene expression in human monocytes. J. Clin. Invest., 81, 1506–1510.

    Article  PubMed  CAS  Google Scholar 

  • Saunders, N. A., Powles, A. C. P., & Rebuck, A. S. (1976). Ear oximetry: Accuracy and practicability in the assessment of arterial oxygenation. Am. Rev. Respir. Dis., 113, 745–749.

    PubMed  CAS  Google Scholar 

  • Shalaby, M. R., Aggarwal, B. B., Rinderknecht, E., Svedersky, L. P., Finkle, B. S., Palladino, M. A., Jr. (1995). Activation of human polymorphonuclear neutrophil functions by interferon-gamma and tumor necrosis factors. J. Immunol., 135, 2069–2073.

    Google Scholar 

  • Shannon, D. C. (1989). Rational monitoring of respiratory function during mechanical ventilation of infants and children. Intens. Cure Med., 15(Suppl. 1), S13–S16.

    Article  Google Scholar 

  • Shapiro, L., & Gelfand, J. A. (1993). Cytokines and sepsis: pathophysiology and therapy. New Horiz., I, 13–22.

    Google Scholar 

  • Smith, A. L. (1998). Treatment of septic shock with immunotherapy. Pharmacotherapy, 18, 565–580.

    PubMed  CAS  Google Scholar 

  • Spies, T, Morton, C. C., & Nedospasov, S. A., Fiers, W., Pious, D., & Strominger, J. L. (1986). Genes for the TNF-alpha and TNF-beta are linked to the human MHC. Proc. Natl. Acad. Sci. USA, 83, 8699–8702.

    Article  PubMed  CAS  Google Scholar 

  • Valenti, W. M., Trudell, R. G., & Bentley, D. W. (1978). Factors predisposing to oropharyngeal colonization with gram-negative bacteria in the aged. N. Engl. J. Med., 298, 1108–1111.

    Article  PubMed  CAS  Google Scholar 

  • Van der Poll, T., Malefyr, R. D., Coyle, S. M., & Lowry, S. F. (1997). Anti-inflammatory cytokine responses during sepsis and experimental endotoxemia: sequential measurements of plasma soluble interleukin (IL)-l receptor type II, 11–10, 11–13. J. Infect. Dis., 175, 118–122.

    PubMed  Google Scholar 

  • Verghese, A., & Beck, S. L. (1983). Bacterial pneumonia in the elderly. Medicine (Baltimore), 62, 271–285.

    CAS  Google Scholar 

  • Voelkel, N. F. (1986). Mechanisms of hypoxic pulmonary vasoconstriction. Am. Rev. Respir. Dis., 133, 1186–1195.

    PubMed  CAS  Google Scholar 

  • Walmrath, D., Schneider, T, Pilch, J., Schermuly, R., Grimininger, F., & Seeger, W. (1995). Effects of aerosolized prostacyclin in severe pneumonia. Am. J. Respir. Crit. Care Med., 151, 724–730.

    PubMed  CAS  Google Scholar 

  • Wheeler, A. P., & Bernard, G. R. (1999). Treating patients with severe sepsis. N. Engl. J. Meil., 340, 207–214.

    Article  CAS  Google Scholar 

  • Yelderman, M. & New, W. (1983). Evaluation of pulse oximetry. Anesthesiology, 59, 349–352.

    Article  PubMed  CAS  Google Scholar 

  • Yoshikawa, T. T. (1991). Treatment of nursing home acquired pneumonia. J. Am. Geriatr. Soc., 39, 1040–1041.

    PubMed  CAS  Google Scholar 

  • Zasloff, M. (1992). Antibiotic peptides as mediators of innate immunity. Curr. Opin. Immunol., 4, 3–7.

    Article  PubMed  CAS  Google Scholar 

  • Zieher, B. G., & Hornick, M. D. (1996). Pathogenesis of respiratory infections and host defenses. Curr. Opin. Pulm. Med., 2, 166.

    Google Scholar 

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Patrick, W. (2002). Pathophysiology of Pneumonia and the Clinical Consequences. In: Marrie, T.J. (eds) Community-Acquired Pneumonia. Springer, Boston, MA. https://doi.org/10.1007/0-306-46834-4_11

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