To the best of our knowledge, this is the first study that explicitly examined the volume-outcome relationship of pneumonia patients in the non-elderly population; a population for which we considered that the relationship could not readily generalized from that in the elderly pneumonia population.
Second, we focused on evaluating the specific effect of hospital case volume on the outcomes of pneumonia treatment explicitly in a non-elderly population.
Equal volumes of M. pneumoniae bacteria fluid (concentration: 10 CCU/mL) and drug (diluted to the desired concentrations with M. pneumoniae medium) were incubated in an incubator at 37°C, with 5% CO2.
On the other hand, Lin and colleagues [ 22], in their study on the relationship between physician case volume and in-hospital mortality of pneumonia patients treated in Intensive Care Units in Taiwan, reported an attenuated strength of association in the severest (acute respiratory failure) patient group.
Hospital case volume was defined as the number of pneumonia patients discharged from each hospital during the 6-month period of the study.
A comparison of the two groups is shown below: Post operative ventilation with large tidal volumes does not reduce the incidence of pneumonia.
aCl: clearance; NR: not reported; PK: pharmacokinetics; T1/2: half-life; VAP: ventilator-associated pneumonia; Vd: volume of distribution.
Patients were also excluded if they had been admitted to a hospital with a pneumonia case volume of only one patient during the study period.
In a rat model of pneumonia, MV with high tidal volume causes pro-coagulant changes and attenuated fibrinolysis in the lungs with alterations in systemic fibrin turnover [ 27].
For induction of pneumonia, bacteria were administered intranasally (total volume 50 μl) under light anaesthesia by inhalation of isoflurane (Abbott, Kent, UK) as described previously [ 27, 28].
The resultant inflammatory response may cause higher fluid resuscitation volumes, progressive pulmonary dysfunction, prolonged ventilator days, increased risk of pneumonia, and acute respiratory distress syndrome (ARDS) [ 2, 3].
