27th May 2025

A 40-year-old man presented with a 3-day history of high fever, shortness of breath and cough productive of yellow sputum.

A 40-year-old man presented with a 3-day history of high fever, shortness of breath and cough productive of yellow sputum.

On arrival to A & E, he was confused with GCS of 13.

Observations after initial management with IV antibiotics and 1L of IV colloid are as follows:

Pulse: 145/min

BP 85/55

Respiratory rate 40 breaths/min 

Oxygen saturation on FiO2 0.6 80%

CXR shows extensive bibasal pneumonia. Blood tests show raised inflammatory markers and acute kidney injury stage 2.

What is the next most appropriate intervention?

Select the SINGLE most appropriate option from the list below. Select ONE option only.