A 63-year-old male,post head trauma,is intubated and has been mechanically ventilated for 78 hours.The respiratory therapist notes the following during ICU rounds: partial pressure of oxygen in the arteries (PaO₂) is 82 mm Hg on 60% supplemental oxygen with a positive end-expiratory pressure (PEEP) of 8 cm H₂O;static compliance is averaging 38 to 41 cm H₂O/L,breath sounds are diminished bilaterally.Bronchoalveolar lavage (BAL) results are pending,but MRSA is suspected.Chest radiograph shows bilateral,patchy infiltrates.Patient has a temperature of 38.8°C,and the most recent white blood cell (WBC) count is 11,300 $\mu$
L.The most appropriate recommendation for this patient is which of the following?

Question

A 63-year-old male,post head trauma,is intubated and has been mechanically ventilated for 78 hours.The respiratory therapist notes the following during ICU rounds: partial pressure of oxygen in the arteries (PaO₂) is 82 mm Hg on 60% supplemental oxygen with a positive end-expiratory pressure (PEEP) of 8 cm H₂O;static compliance is averaging 38 to 41 cm H₂O/L,breath sounds are diminished bilaterally.Bronchoalveolar lavage (BAL) results are pending,but MRSA is suspected.Chest radiograph shows bilateral,patchy infiltrates.Patient has a temperature of 38.8°C,and the most recent white blood cell (WBC) count is 11,300

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L.The most appropriate recommendation for this patient is which of the following?

Quizplus · Accepted Answer

This patient has late-onset ventilator-associated pneumonia,because he has been intubated and has received mechanical ventilation for longer than 72 hours.Because MRSA is suspected,combination antibiotic therapy should be used.According to Table 14-2 this would include two antipseudomonal agents plus either vancomycin or linezolid.Therapy should be adjusted once the microbiological data confirm the organism.

A 63-Year-Old Male,post Head Trauma,is Intubated and Has Been Mechanically μ\muμ

A 63-Year-Old Male,post Head Trauma,is Intubated and Has Been Mechanically $\mu$