Pneumonia is the most prevalent infectious respiratory disease. It entails high morbidity and mortality and large health system expenses.
Community-acquired pneumonia (CAP) is one of the five leading causes of death in the world. Approximately 20% of CAP patients require hospitalisation, 25% of which require intensive care unit (ICU) admission, and their mortality rate is of 40–50% (Alvarez-Lerma and Torres 2004).
Furthermore, 20–30% of patients under mechanical ventilation for at least 48 h in the ICU develop mechanical ventilation-associated pneumonia (VAP). Mortality attributable to VAP is also higher than 30%, being the leading cause of morbidity and mortality in patients with ICU-acquired nosocomial infections (ATS 2005).
Despite the progress in life support measures and in antimicrobial therapy, with the use of new antibiotics more efficient every time and with a broader spectrum, mortality of severe pneumonia has not varied during the last years (Lepper and Torres 1995; Heyland et al. 1999), suggesting that other factors are of crucial importance in the evolution of this respiratory infection.
One of the key factors determining the evolution of pneumonia is the host inflammatory response, increased excessively both in non-responding severe CAP and in VAP (Menéndez et al. 2004; Ioanas et al. 2004).
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Agustí, C., Sibila, O., Torres, A. (2008). Corticoids in Severe Pneumonia. In: Rello, J., Restrepo, M.I. (eds) Sepsis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-79001-3_4
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