Approach to the Immunocompromised Host with Infection in the Intensive Care Unit

Linden, Peter K.

doi:10.1016/j.idc.2009.04.014

Cited by 41 publications

(30 citation statements)

References 66 publications

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“…The number of immunocompromised patients has increased dramatically over recent decades [2]. In spite of better antimicrobial agents and preventive measures, infections continue to be one of the most frequent complications in immunocompromised patients and have a high mortality rate of 30 to 90 % [2], with the highest when acute respiratory failure (ARF) occurs. Thus, early diagnosis and proper intervention are essential for better outcomes.…”

Section: Introductionmentioning

confidence: 99%

Noninvasive versus invasive mechanical ventilation for immunocompromised patients with acute respiratory failure: a systematic review and meta-analysis

et al. 2016

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BackgroundTo determine the effects of noninvasive mechanical ventilation (NIV) compared with invasive mechanical ventilation (IMV) as the initial mechanical ventilation on clinical outcomes when used for treatment of acute respiratory failure (ARF) in immunocompromised patients.MethodsWe searched PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), the Chinese Biomedical Literature Database (CBM) and other databases. Subgroup analyses by disease severity and causes of immunodeficiency were also conducted.ResultsThirteen observational studies with a total of 2552 patients were included. Compared to IMV, NIV was shown to significantly reduce in-hospital mortality (OR 0.43, 95 % CI 0.23 to 0.80, P value = 0.007) and 30-day mortality (OR 0.34, 95 % CI 0.20 to 0.61, P value < 0.0001) in overall analysis. Subgroup analysis showed NIV had great advantage over IMV for less severe, AIDS, BMT and hematological malignancies patients in reducing mortality and duration of ICU stay.ConclusionsThe overall evidence we obtained shows NIV does more benefits or at least no harm to ARF patients with certain causes of immunodeficiency or who are less severe.Electronic supplementary materialThe online version of this article (doi:10.1186/s12890-016-0289-y) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Noninvasive versus invasive mechanical ventilation for immunocompromised patients with acute respiratory failure: a systematic review and meta-analysis

et al. 2016

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“…In addition, biologic markers of CMV pp65 or CMV DNA by polymerase chain reaction are detectable at very early stages of infection. 70,71 To combat the effects of CMV infection, aggressive antiviral prophylaxis with valganciclovir or ganciclovir for up to 3 months following liver transplant is often employed. This approach, however, may result in delayed onset CMV disease once antivirals are discontinued.…”

Section: Ascariasismentioning

confidence: 99%

Imaging of Biliary Infections

Catalano

Arellano

2017

Dig Dis Interv

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“…Furthermore, although the number of hospitalized patients with AIDS has declined, there is a growing number of other types of patients with compromised immune systems who require critical care services, many of them for complex infectious problems that involve unusual pathogens [16]. This "new age" immunocompromised population includes recipients of highrisk allogeneic hematopoietic stem cell and organ transplantation, myeloablative and cytotoxic chemotherapy, monoclonal antibodies, and other cellular and biological immunomodulating therapies.…”

Section: Synergy Of Ccm-id In the Clinical And Research Arenasmentioning

confidence: 99%

Critical Care Medicine and Infectious Diseases: An Emerging Combined Subspecialty in the United States: Figure 1.

et al. 2015

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The recent rise in unfilled training positions among infectious diseases (ID) fellowship programs nationwide indicates that ID is declining as a career choice among internal medicine residency graduates. Supplementing ID training with training in critical care medicine (CCM) might be a way to regenerate interest in the specialty. Hands-on patient care and higher salaries are obvious attractions. High infection prevalence and antibiotic resistance in intensive care units, expanding immunosuppressed host populations, and public health crises such as the recent Ebola outbreak underscore the potential synergy of CCM-ID training. Most intensivists receive training in pulmonary medicine and only 1% of current board-certified intensivists are trained in ID. While still small, this cohort of CCM-ID certified physicians has continued to rise over the last 2 decades. ID and CCM program leadership nationwide must recognize these trends and the merits of the CCM-ID combination to facilitate creation of formal dual-training opportunities.

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Approach to the Immunocompromised Host with Infection in the Intensive Care Unit

Cited by 41 publications

References 66 publications

Noninvasive versus invasive mechanical ventilation for immunocompromised patients with acute respiratory failure: a systematic review and meta-analysis

Noninvasive versus invasive mechanical ventilation for immunocompromised patients with acute respiratory failure: a systematic review and meta-analysis

Imaging of Biliary Infections

Critical Care Medicine and Infectious Diseases: An Emerging Combined Subspecialty in the United States: Figure 1.

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