Which supportive measures are indicated in the management of bacterial pneumonia?

Updated: Sep 30, 2020
  • Author: Justina Gamache, MD; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Answer

Supportive measures include the following (some were mentioned previously):

  • Analgesia and antipyretics

  • Chest physiotherapy

  • Intravenous fluids (and, conversely, diuretics) if indicated

  • Monitoring – Pulse oximetry with or without cardiac monitoring, as indicated

  • Oxygen supplementation

  • Positioning of the patient to minimize aspiration risk

  • Respiratory therapy, including treatment with bronchodilators and, perhaps, N -acetylcysteine in selected patients

  • Suctioning and bronchial hygiene – Pulmonary toilet may include active suction of secretions, chest physiotherapy, positioning to promote dependent drainage, and incentive spirometry to enhance elimination of purulent sputum and to avoid atelectasis.

  • Mechanical ventilatory support with low tidal volumes (6 mL/kg of ideal body weight) in patients with respiratory failure secondary to bilateral pneumonia or acute respiratory distress syndrome (ARDS) [3]

  • Systemic support may include proper hydration, nutrition, and early mobilization to create a positive host milieu to fight infection and speed recovery. Early mobilization of patients, with encouragement to sit, stand, and walk when tolerated, speeds recovery.


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