Nohra Eden, Appelbaum Rachel D, Farrell Michael Steven, Carver Thomas, Jung Hee Soo, Kirsch Jordan Michael, Kodadek Lisa M, Mandell Samuel, Nassar Aussama Khalaf, Pathak Abhijit, Paul Jasmeet, Robinson Bryce, Cuschieri Joseph, Stein Deborah M
Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Trauma Surg Acute Care Open. 2024 Jun 3;9(1):e001303. doi: 10.1136/tsaco-2023-001303. eCollection 2024.
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.
发热的评估与检查以及使用抗生素治疗感染是外科重症监护病房（ICU）日常工作的一部分。发热可能是感染性的或非感染性的；尽可能区分这两种情况很重要。缩短常见感染抗生素治疗疗程的证据越来越多。这份由美国创伤外科协会重症监护委员会制定的临床共识文件的目的是综合现有证据，并提供实用建议。我们讨论发热的评估、获取用于诊断感染的培养物（包括尿液、血液和呼吸道标本）的指征、降钙素原的使用以及开始经验性使用抗生素的决策。然后我们描述常见感染的治疗，特别是呼吸机相关性肺炎、导管相关性尿路感染、导管相关血流感染、菌血症、手术部位感染、腹腔内感染、脑室炎和坏死性软组织感染。
