Fever and infections in surgical intensive care: an American Association for the Surgery of Trauma Critical Care Committee clinical consensus document

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 sho...

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Main Authors: Deborah M Stein, Hee Soo Jung, Lisa M Kodadek, Bryce Robinson, Aussama Khalaf Nassar, Joseph Cuschieri, Michael Steven Farrell, Abhijit Pathak, Samuel Mandell, Jasmeet Paul, Rachel D Appelbaum, Eden Nohra, Thomas Carver, Jordan Michael Kirsch
Format: Article
Language:English
Published: BMJ Publishing Group 2024-04-01
Series:Trauma Surgery & Acute Care Open
Online Access:https://tsaco.bmj.com/content/9/1/e001303.full
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Summary: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.
ISSN:2397-5776