TY - JOUR T1 - Community-acquired pneumonia in critically ill very old patients: a growing problem JF - European Respiratory Review JO - EUROPEAN RESPIRATORY REVIEW DO - 10.1183/16000617.0126-2019 VL - 29 IS - 155 SP - 190126 AU - Catia Cillóniz AU - Cristina Dominedò AU - Juan M. Pericàs AU - Diana Rodriguez-Hurtado AU - Antoni Torres Y1 - 2020/03/31 UR - http://err.ersjournals.com/content/29/155/190126.abstract N2 - Very old (aged ≥80 years) adults constitute an increasing proportion of the global population. Currently, this subgroup of patients represents an important percentage of patients admitted to the intensive care unit. Community-acquired pneumonia (CAP) frequently affects very old adults. However, there are no specific recommendations for the management of critically ill very old CAP patients. Multiple morbidities, polypharmacy, immunosenescence and frailty contribute to an increased risk of pneumonia in this population. CAP in critically ill very old patients is associated with higher short- and long-term mortality; however, because of its uncommon presentation, diagnosis can be very difficult. Management of critically ill very old CAP patients should be guided by their baseline characteristics, clinical presentation and risk factors for multidrug-resistant pathogens. Hospitalisation in intermediate care may be a good option for critical ill very old CAP patients who do not require invasive procedures and for whom intensive care is questionable in terms of benefit.There is currently no international recommendation for the management of critically ill older patients over 80 years of age with CAP. We report and discuss recent literature in order to help physicians in the decision-making process of these patients. http://bit.ly/2ql0mIz ER -