In the case of severe pneumonia combined with respiratory failure in the elderly, the first thing to do is to actively control the infection, and at the same time give respiratory support to correct hypoxia and improve ventilation.
1. Anti-infective treatment: according to the pathogen of the patient’s infection, choose the appropriate antibiotics. For bacterial infection, consider anti-bacterial such as cefoperazone sulbactam, piperacillin tazobactam, etc.; for viral infection, combine with the type of virus to choose antiviral such as ribavirin, acyclovir; and for fungal infection, consider antifungal such as voriconazole and fluconazole.
2. Respiratory support: appropriate oxygen therapy should be given to correct hypoxia, according to the condition, low-flow nasal catheter oxygen or high-concentration mask oxygen can be used. If the patient is combined with severe hypoxemia and hypercapnia, non-invasive mechanical ventilation or invasive mechanical ventilation can be given to give respiratory support therapy to correct respiratory failure.
3. Symptomatic treatment: if sputum is excessive, expectorant treatment should be timely, turn over and pat the back diligently, apply expectorant drugs such as oral acetylcysteine, eucalyptus-pin enteric capsule, intravenous aminobromine, or combined nebulization treatment such as inhalation with compound ipratropium bromide; for bedridden, impaired consciousness, bedside suction to promote sputum drainage can be considered.
Therefore, when the elderly severe pneumonia combined with respiratory failure also need to consult a doctor in time to avoid delaying the condition.