Abstract
It has often been suggested that patients with acute heart failure (AHF) were particularly susceptible to pulmonary infections, the reason being that congested lungs had diminished capacity to clear respiratory secretions and ensure rapid bacterial clearance. To the best of our knowledge, this point has never been clearly investigated. Nonetheless, in AHF, bacterial growth may be favored in injured lungs, in the same way as in the acute respiratory distress syndrome (1). Indeed, experimental studies have shown that cardiogenic hydrostatic pulmonary edema may be accompanied by a certain degree of permeability-type lung edema with cellular damage and capillary stress failure (2–4), enabling erythrocytes to reach the alveolar space (4) and rendering the edema fluid an appropriate milieu for bacterial growth. This is in agreement with the clinical observation that lung infection may precipitate, accompany, or follow AHF and cardiogenic pulmonary edema.
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References
Dreyfuss D, Ricard JD. Acute lung injury and bacterial infection. Clin Chest Med 2005;26:105–12.
Bachofen H, Schurch S, Weibel ER. Experimental hydrostatic pulmonary edema in rabbit lungs. Barrier lesions. Am Rev Respir Dis 1993;147:997–1004.
Bachofen H, Schurch S, Michel RP, et al. Experimental hydrostatic pulmonary edema in rabbit lungs. Morphology Am Rev Respir Dis 1993;147:989–96.
Tsukimoto K, Mathieu-Costello O, Prediletto R, et al. Ultrastructural appearances of pulmonary capillaries at high transmural pressures. J Appl Physiol 1991;71:573–82.
Cleland JGF, Swedberg K, Follath F, et al. The EuroHeart Failure survey programme—a survey on the quality of care among patients with heart failure in Europe: Part 1: patient characteristics and diagnosis. Eur Heart J 2003;24:442–63.
Braunstein JB, Anderson GF, Gerstenblith G, et al. Noncardiac comorbidity increases preventable hospitalizations and mortality among medicare beneficiaries with chronic heart failure. J Am Coll Cardiol 2003;42:1226–33.
Ghali JK, Kadakia S, Cooper R, et al. Precipitating factors leading to decompensation of heart failure. Traits among urban blacks. Arch Intern Med 1988;148:2013–6.
Erk O. Precipitating factors for systolic and diastolic heart failure: a four-year follow-up of 192 patients. Hong Kong Med J 2004;10:97–101.
Sarmento PM, Fonseca C, Marques F, et al. Acutely decompensated heart failure: characteristics of hospitalized patients and opportunities to improve their care. Rev Port Cardiol 2006;25:13–27.
Bartlett JG, Dowell SF, Mandell LA, et al. Practice guidelines for the management of community-acquired pneumonia in adults. Infectious Diseases Society of America. Clin Infect Dis 2000;31:347–82.
Ruiz M, Ewig S, Marcos MA, et al. Etiology of community-acquired pneumonia: impact of age, comorbidity, and severity. Am J Respir Crit Care Med 1999;160:397–405.
Niederman MS, Mandell LA, Anzueto A, et al. Guidelines for the management of adults with community-acquired pneumonia. Diagnosis, assessment of severity, antimicrobial therapy, and prevention. Am J Respir Crit Care Med 2001;163:1730–54.
Christ-Crain M, Jaccard-Stolz D, Bingisser R, et al. Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single-blinded intervention trial. Lancet 2004;363:600–7.
Chastre J, Fagon JY. Ventilator-associated pneumonia. Am J Respir Crit Care Med 2002;165:867–903.
Pugin J, Auckenthaler R, Mili N, et al. Diagnosis of ventilator-associated pneumonia by bacteriologic analysis of bronchoscopic and nonbronchoscopic “blind” bronchoalveolar lavage fluid. Am Rev Respir Dis 1991;143:1121–9
Fartoukh M, Maitre B, Honore S, et al. Diagnosing pneumonia during mechanical ventilation: the clinical pulmonary infection score revisited. Am J Respir Crit Care Med 2003;168:173–9.
Fagon JY, Chastre J, Wolff M, et al. Invasive and noninvasive strategies for management of suspected ventilator-associated pneumonia. A randomized trial. Ann Intern Med 2000;132:621–30.
Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med 2005;171:388–416.
Wysocki M, Delatour F, Faurisson F, et al. Continuous versus intermittent infusion of vancomycin in severe Staphylococcal infections: prospective multicenter randomized study. Antimicrob Agents Chemother 2001;45:2460–7.
Chastre J, Wolff M, Fagon JY, et al. Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults: a randomized trial. JAMA 2003;290:2588–98.
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Roux, D., Ricard, JD. (2008). Pulmonary Disease in the Setting of Acute Heart Failure Syndrome. In: Mebazaa, A., Gheorghiade, M., Zannad, F.M., Parrillo, J.E. (eds) Acute Heart Failure. Springer, London. https://doi.org/10.1007/978-1-84628-782-4_73
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DOI: https://doi.org/10.1007/978-1-84628-782-4_73
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