PDF(Pubmed)
Abstract：
The evaluation and workup of fever and the use of antibiotics to treat infections is part of daily practice in the surgical intensive care unit (ICU). Fever can be infectious or non-infectious; it is important to distinguish between the two entities wherever possible. The evidence is growing for shortening the duration of antibiotic treatment of common infections. The purpose of this clinical consensus document, created by the American Association for the Surgery of Trauma Critical Care Committee, is to synthesize the available evidence, and to provide practical recommendations. We discuss the evaluation of fever, the indications to obtain cultures including urine, blood, and respiratory specimens for diagnosis of infections, the use of procalcitonin, and the decision to initiate empiric antibiotics. We then describe the treatment of common infections, specifically ventilator-associated pneumonia, catheter-associated urinary infection, catheter-related bloodstream infection, bacteremia, surgical site infection, intra-abdominal infection, ventriculitis, and necrotizing soft tissue infection.
摘要：
发烧的评估和检查以及使用抗生素治疗感染是外科重症监护病房（ICU）日常实践的一部分。发烧可以是传染性的或非传染性的;重要的是尽可能区分这两个实体。越来越多的证据表明缩短常见感染的抗生素治疗持续时间。本临床共识文件的目的，由美国创伤外科协会重症监护委员会创建，就是综合现有的证据,并提出切实可行的建议。我们讨论发烧的评估，获得包括尿液在内的培养物的适应症，血,和用于诊断感染的呼吸道标本，使用降钙素原，以及开始使用经验性抗生素的决定。然后我们描述常见感染的治疗方法，特别是呼吸机相关性肺炎，导管相关性尿路感染,导管相关性血流感染,菌血症,手术部位感染,腹腔感染,脑室炎,和坏死性软组织感染。
