{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T15:03:00Z","timestamp":1790780580086,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,7,28]],"date-time":"2014-07-28T00:00:00Z","timestamp":1406505600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2016,1]]},"abstract":"Abstract<\/jats:title>Background and Aims<\/jats:title>Severe community\u2010acquired pneumonia (sCAP<\/jats:styled-content>) have been as defined pneumonia requiring admission to the intensive care unit or carrying a high risk of death. Currently, the treatment of sCAP<\/jats:styled-content> consists of antibiotic therapy and ventilator support. The use of invasive ventilation causes several complications as does admission to ICU<\/jats:styled-content>. For this reason, non\u2010invasive ventilation (NIV<\/jats:styled-content>) has been used for acute respiratory failure to avoid endotracheal intubation. However, few studies have currently assessed the usefulness of NIV<\/jats:styled-content> in sCAP<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>We prospectively assessed 127 patients with sCAP<\/jats:styled-content> and severe acute respiratory failure [oxygen arterial pressure\/oxygen inspiratory fraction ratio (P<\/jats:styled-content>aO<\/jats:styled-content>2<\/jats:sub>\/F<\/jats:styled-content>iO<\/jats:styled-content>2<\/jats:sub>) <250]. We defined successful NIV<\/jats:styled-content> as avoidance of intubation and the achievement of P<\/jats:styled-content>aO<\/jats:styled-content>2<\/jats:sub>\/F<\/jats:styled-content>iO<\/jats:styled-content>2<\/jats:sub> >250 with spontaneous breathing. We assessed predictors of NIV<\/jats:styled-content> failure and hospital mortality using univariate and multivariate analyses.<\/jats:p><\/jats:sec>Results<\/jats:title>NIV<\/jats:styled-content> failed in 32 patients (25.1%). Higher chest X<\/jats:styled-content>\u2010ray score at admission, chest X<\/jats:styled-content>\u2010ray worsening, and a lower P<\/jats:styled-content>aO<\/jats:styled-content>2<\/jats:sub>\/F<\/jats:styled-content>iO<\/jats:styled-content>2<\/jats:sub> and higher alveolar\u2010arteriolar gradient (A<\/jats:styled-content>\u2010aDO<\/jats:styled-content>2<\/jats:sub>) after 1\u2009h of NIV<\/jats:styled-content> all independently predicted NIV<\/jats:styled-content> failure. Higher lactate dehydrogenase and confusion, elevated blood urea, respiratory rate, blood pressure plus age \u226565 years at admission, higher A<\/jats:styled-content>\u2010aDO<\/jats:styled-content>2<\/jats:sub>, respiratory rate and lower P<\/jats:styled-content>aO<\/jats:styled-content>2<\/jats:sub>\/FiO<\/jats:styled-content>2<\/jats:sub> after 1\u2009h of NIV<\/jats:styled-content> and intubation rate were directly related to hospital mortality.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Successful treatment is strongly related to less severe illness as well as to a good initial and sustained response to medical therapy and NIV<\/jats:styled-content> treatment. Constant monitoring of these patients is mandatory.<\/jats:p><\/jats:sec>","DOI":"10.1111\/crj.12184","type":"journal-article","created":{"date-parts":[[2014,7,11]],"date-time":"2014-07-11T08:55:00Z","timestamp":1405068900000},"page":"98-103","source":"Crossref","is-referenced-by-count":35,"title":["Early non\u2010invasive ventilation treatment for respiratory failure due to severe community\u2010acquired pneumonia"],"prefix":"10.1111","volume":"10","author":[{"given":"Antonello","family":"Nicolini","sequence":"first","affiliation":[{"name":"Respiratory Diseases Unit ASL4 Chiavarese Sestri Levante Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Ferraioli","sequence":"additional","affiliation":[{"name":"Emergency Medicine Unit ASL4 Chiavarese Lavagna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maura","family":"Ferrari\u2010Bravo","sequence":"additional","affiliation":[{"name":"Public Health Unit ASL4 Chiavarese 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