Criteria for Intensive Care Admission in Hospital-Acquired Pneumonia (HAP):
Admission to intensive care should be considered for patients with hospital-acquired pneumonia who exhibit signs of severe illness such as respiratory failure, septic shock, or multi-organ dysfunction.
Key clinical indicators include: respiratory rate ≥30 breaths per minute, oxygen saturation <90% on room air, hypotension (systolic <90 mmHg or diastolic ≤60 mmHg), altered mental status (confusion or new disorientation), and inability to eat without assistance.
Patients with hospital-acquired pneumonia who require invasive or non-invasive mechanical ventilation or vasopressor support should be admitted to intensive care.
Decisions should also consider comorbidities, frailty, and the trajectory of the illness, with early specialist assessment recommended for deteriorating patients.
In summary, ICU admission for hospital-acquired pneumonia is based on the presence of severe respiratory compromise, hemodynamic instability, altered mental status, and the need for organ support, guided by clinical judgement rather than a formal scoring system.
References: This approach aligns with NICE guidance on pneumonia in adults and clinical practice recommendations emphasizing clinical judgement and severity markers for hospital-acquired pneumonia management NICE CG191,NICE CKS.