Diagnosis and treatment of invasive pulmonary aspergillosis in critically ill intensive care patients: executive summary of the German national guideline (AWMF 113-005).
Purpose: The executive summary of the guideline aims to provide the most relevant recommendations on the diagnosis and treatment of invasive pulmonary aspergillosis in critically ill patients in the intensive care unit. Methods: The guideline's work included a systematic literature search, selection...
| Publicado en: | Infection Vol. 53; no. 4; pp. 1299 - 1311 |
|---|---|
| Autores principales: | , , , , , , , , , , , |
| Formato: | practice guidelines review tables/charts Journal Article |
| Publicado: |
Springer Nature
Aug2025
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=187120491&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 187120491 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03008126 NXO jtl: Infection issn: 03008126 maglogo: N pubinfo: dt: Aug2025 vid: 53 iid: 4 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 187120491 185675623 187120491 187120491 10.1007/s15010-025-02572-2 187120491 ppf: 1299 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Diagnosis and treatment of invasive pulmonary aspergillosis in critically ill intensive care patients: executive summary of the German national guideline (AWMF 113-005). aug: au: Wichmann, Dominic Hoenigl, Martin Koehler, Philipp Koenig, Christina Lund, Frederike Mang, Sebastian Strauß, Richard Weigand, Markus A. Hohmann, Christian Kurzai, Oliver Heußel, Claus Kochanek, Matthias affil: https://ror.org/01zgy1s35 Department of Intensive Care Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany sug: subj: Invasive Pulmonary Aspergillosis Diagnosis Invasive Pulmonary Aspergillosis Drug Therapy Critical Care Critically Ill Patients Intensive Care Units Practice Guidelines Physicians, Emergency Neutropenia Complications Hematopoietic Stem Cell Transplantation Adverse Effects Hematologic Neoplasms Complications Organ Transplantation Adverse Effects Acquired Immunodeficiency Syndrome Complications Voriconazole Administration and Dosage Antifungal Agents Administration and Dosage Administration, Intravenous Invasive Pulmonary Aspergillosis Risk Factors Risk Assessment Primary Immunodeficiency Diseases Complications Guideline Adherence Amphotericin B Administration and Dosage Peptides Administration and Dosage ab: Purpose: The executive summary of the guideline aims to provide the most relevant recommendations on the diagnosis and treatment of invasive pulmonary aspergillosis in critically ill patients in the intensive care unit. Methods: The guideline's work included a systematic literature search, selection and assessment of the data relevant to the issues identified. Key questions included the areas of epidemiology, risk factors, diagnostics, and therapy. They were discussed analogous to a PICO scheme within the guideline committee, with subsequent working groups proposing recommendations for specific key questions, which were then again discussed and finalized by the entire guideline committee. Results: In addition to the classic risk factors (persistent neutropenia, allogeneic stem cell transplantation, congenital or acquired immunodeficiency, etc.), decompensated liver cirrhosis, COPD, solid tumours and viral pneumonia (influenza, COVID-19) have been established as risk factors for critically ill patients in need of intensive care. If there is no adequate improvement or even further clinical deterioration of the respiratory status in critically ill patients, the presence of IPA should be considered and appropriate diagnostic tests should be initiated. Diagnostics should include a CT scan of the chest and a broncho-alveolar lavage with culture for moulds, testing for galactomannan and PCR. Isavuconazole and voriconazole are recommended as first-line treatment, liposomal amphotericin B as an alternative, with posaconazole (PCZ) or the echinocandins (as an add-on to azole or polyene treatment) being additional options for salvage treatment. Conclusion: Invasive aspergillosis in critically ill patients represents a diagnostic and therapeutic challenge. If indicated, invasive aspergillosis should be considered and appropriate diagnostic tests initiated. Isavuconazole and voriconazole are recommended as first-line treatment, liposomal amphotericin B as an alternative. pubtype: Academic Journal doctype: practice guidelines review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|