Criteria for ICU admission in case of community-acquired pneumonia.





 One of the major or three or more of the minor criteria would indicate ICU admission (IDSA/ATS guidelines):

Major criteria
  ◆   Invasive mechanical ventilation.

  ◆   Septic Shock with the need for vasopressors.

Minor criteria
  ◆   Respiratory rate ≥ 30 breaths/min.
  ◆   PaO2/FiO2 ≤ 250.
  ◆   Multilobar infiltrates.
  ◆   Confusion disorientation.
  ◆   Uraemia (blood urea nitrogen (BUN) level ≥ 20 mg/dL).
  ◆   Leucopenia (white blood cell count < 4 × 109/L).
  ◆   Thrombocytopenia (platelet count < 100 × 109/L).
  ◆   Hypothermia (core temperature < 36ºC).
  ◆   Hypotension  (SBP  < 90  mmHg)  requiring  aggressive  fluid resuscitation.


 Of the novel biomarkers,  most  attention  has  been  focused  on  procalcitonin. Inflammatory biomarkers (C-reactive protein (CRP), tumour necrosis factor-a, procalcitonin and interleukin-6) identified patients needing ICU admission. Patients with severe CAP by minor criteria and low levels of procalcitonin may be safely admitted to wards.

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