■由于使用广谱抗生素,重症监护病房(ICU)中的侵袭性真菌感染(FI)是一个新出现的问题,免疫抑制剂,和留置导管的频率。及时诊断对改善结果至关重要可能具有挑战性。这份立场声明旨在了解风险因素,提供合理的诊断方法,指导临床医生优化抗真菌治疗。
■为了更新流行病学证据,危险因素,诊断方法,抗真菌起始策略,治疗性干预措施,包括部位特异性感染和治疗药物监测在ICU中的作用,并关注与这些领域相关的一些实践要点。
■成立了一个由全国各地的重症监护专家组成的委员会,并将真菌感染和抗真菌治疗的特定方面分配给每个成员。他们广泛审查了包括电子数据库和国际指南和交叉引用在内的文献。在几次会议上分享和讨论了这些信息,并制定了立场声明的框架,以确保其在关键实践中的可靠性和相关性。文件草案是在获得所有成员的投入和共识后编写的,并由该领域的专家进行了审查。
■更新了现有的关于国际金融机构管理的证据,并在每个子标题下准备了实践点,以使重症监护医师能够简化ICU患者的诊断和治疗策略,并进一步详细了解特定部位的感染治疗药物监测。
■本立场声明试图解决免疫功能正常和非中性粒细胞减少性ICU患者的国际金融机构管理。实践要点应指导优化疑似或确诊为真菌感染的危重患者的管理。
■BhattacharyaPK,查克拉巴蒂A,SinhaS,潘德R,GuptaS,KumarAAK,etal.ISCM关于重症监护病房侵袭性真菌感染管理的立场声明。印度J暴击护理中心2024;28(S2):S20-S41。
UNASSIGNED: Invasive fungal infections (IFI) in the intensive care unit (ICU) are an emerging problem owing to the use of broad-spectrum antibiotics, immunosuppressive agents, and frequency of indwelling catheters. Timely diagnosis which is imperative to improve outcomes can be challenging. This position statement is aimed at understanding risk factors, providing a rational diagnostic approach, and guiding clinicians to optimize antifungal therapy.
UNASSIGNED: To update evidence on epidemiology, risk factors, diagnostic approach, antifungal initiation strategy, therapeutic interventions including site-specific infections and role of therapeutic drug monitoring in IFI in ICU and focus on some practice points relevant to these domains.
UNASSIGNED: A committee comprising critical care specialists across the country was formed and specific aspects of fungal infections and antifungal treatment were assigned to each member. They extensively reviewed the literature including the electronic databases and the international guidelines and cross-references. The information was shared and discussed over several meetings and position statements were framed to ensure their reliability and relevance in critical practice. The draft document was prepared after obtaining inputs and consensus from all the members and was reviewed by an expert in this field.
UNASSIGNED: The existing evidence on the management of IFI was updated and practice points were prepared under each subheading to enable critical care practitioners to streamline diagnosis and treatment strategies for patients in the ICU with additional detail on site-specific infections therapeutic drug monitoring.
UNASSIGNED: This position statement attempts to address the management of IFI in immunocompetent and non-neutropenic ICU patients. The practice points should guide in optimization of the management of critically ill patients with suspected or proven fungal infections.
UNASSIGNED: Bhattacharya PK, Chakrabarti A, Sinha S, Pande R, Gupta S, Kumar AAK, et al. ISCCM Position Statement on the Management of Invasive Fungal Infections in the Intensive Care Unit. Indian J Crit Care Med 2024;28(S2):S20-S41.