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Management of neutropenic patients in the intensive care unit (NEWBORNS EXCLUDED) recommendations from an expert panel from the French Intensive Care Society (SRLF) with the French Group for Pediatric Intensive Care Emergencies (GFRUP), the French Society of Anesthesia and Intensive Care (SFAR), the French Society of Hematology (SFH), the French Society for Hospital Hygiene (SF2H), and the French Infectious Diseases Society (SPILF)
Author(s) -
David Schnell,
Élie Azoulay,
Dominique Benoît,
Benjamin Clouzeau,
Pierre Demaret,
Stéphane Ducassou,
Pierre Frange,
Matthieu Lafaurie,
Matthieu Legrand,
AnnePascale Meert,
Djamel Mokart,
J. Naudin,
Frédéric Pène,
Antoine Rabbat,
Emmanuel Raffoux,
Patricia Ribaud,
Jean-Christophe M. Richard,
François Vincent,
JeanRalph Zahar,
Michaël Darmon
Publication year - 2016
Publication title -
annals of intensive care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.281
H-Index - 49
ISSN - 2110-5820
DOI - 10.1186/s13613-016-0189-6
Subject(s) - medicine , intensive care unit , intensive care , anesthesiology , intensive care medicine , isolation (microbiology) , anesthesia , microbiology and biotechnology , biology
Neutropenia is defined by either an absolute or functional defect (acute myeloid leukemia or myelodysplastic syndrome) of polymorphonuclear neutrophils and is associated with high risk of specific complications that may require intensive care unit (ICU) admission. Specificities in the management of critically ill neutropenic patients prompted the establishment of guidelines dedicated to intensivists. These recommendations were drawn up by a panel of experts brought together by the French Intensive Care Society in collaboration with the French Group for Pediatric Intensive Care Emergencies, the French Society of Anesthesia and Intensive Care, the French Society of Hematology, the French Society for Hospital Hygiene, and the French Infectious Diseases Society. Literature review and formulation of recommendations were performed using the Grading of Recommendations Assessment, Development and Evaluation system. Each recommendation was then evaluated and rated by each expert using a methodology derived from the RAND/UCLA Appropriateness Method. Six fields are covered by the provided recommendations: (1) ICU admission and prognosis, (2) protective isolation and prophylaxis, (3) management of acute respiratory failure, (4) organ failure and organ support, (5) antibiotic management and source control, and (6) hematological management. Most of the provided recommendations are obtained from low levels of evidence, however, suggesting a need for additional studies. Seven recommendations were, however, associated with high level of evidences and are related to protective isolation, diagnostic workup of acute respiratory failure, medical management, and timing surgery in patients with typhlitis. Electronic supplementary material The online version of this article (doi:10.1186/s13613-016-0189-6) contains supplementary material, which is available to authorized users.

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