Therapeutic advances in pulmonary and critical care medicine最新文献

{"title":"Diagnostic Value of Cryptococcal Glucuronoxylomannan Antigen Testing of Bronchoalveolar Lavage Fluid for Pulmonary Cryptococcosis in Immunocompetent Patients: A Clinical Study.","authors":"Shuangxia Dong, Xinjian Dai, Linyan Pang, Yang Huang","doi":"10.1177/29768675251363301","DOIUrl":"10.1177/29768675251363301","url":null,"abstract":"<p><strong>Background: </strong>[No revision is required.]Pulmonary cryptococcosis (PC) is common in immunocompetent patients, and its early diagnosis is challenging. Multiple studies have addressed the detection of cryptococcal glucuronoxylomannan (GXM) antigen in serum, but few have investigated its detection in bronchoalveolar lavage fluid (BALF).</p><p><strong>Objectives: </strong>To evaluate the diagnostic value of the <i>Cryptococcus</i> GXM antigen test in BALF for PC in immunocompetent patients.</p><p><strong>Design: </strong>We collect the clinical data of 138 patients from October 2018 to March 2023 and divide them into a PC group (n = 48) and a non-PC group (n = 90). Perform serum and BALF GXM antigen test on all cases that meet the inclusion criteria.</p><p><strong>Methods: </strong>To analyze and compare the clinical characteristics of the PC group and non-PC group. We calculate the positive detection rate (PDR) and negative predictive value of BALF and serum GXM antigen tests, as well as their combination, for the PC group.</p><p><strong>Results: </strong>Most patients in the PC group are male (59.6%), with an average age of 49.4 years. Most of the patients have no underlying disease (51.9%). Diabetes and hypertension are the most common comorbidities. Most patients (53.8%) are asymptomatic. Cough and sputum are the most frequent clinical symptoms, followed by fever and chest distress. Nodules and exudative consolidation are the most common imaging findings, and the culture positivity rate is 25%. Forty patients are positive according to the BALF GXM test, for a positivity rate of 83.3% and a negative predictive value of 91.8%. Moreover, 39 patients are positive according to the serum GXM test, for a positivity rate of 81.3% and a negative predictive value of 90.9%. The positivity rate for serum plus BALF is 95.8%. There is no significant difference (P > 0.05) in diagnostic value between BALF and serum GXM tests for PC. GXM positivity rates differ significantly among paired BALF, serum, and BALF plus serum groups (P < 0.05).</p><p><strong>Conclusion: </strong>The BALF GXM test is useful for the early diagnosis of PC in immunocompetent patients. Simultaneous BALF and serum GXM testing would increase the rate of early PC diagnosis in immunocompetent patients.</p>","PeriodicalId":94361,"journal":{"name":"Therapeutic advances in pulmonary and critical care medicine","volume":"20 ","pages":"29768675251363301"},"PeriodicalIF":3.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Jugular Venous Doppler Ultrasound as a Non-Invasive Window to Right Heart Hemodynamics: A Narrative Review and Future Perspective.","authors":"Jon-Emile S Kenny, Philippe Rola, Ross Prager, Korbin Haycock","doi":"10.1177/29768675251359700","DOIUrl":"10.1177/29768675251359700","url":null,"abstract":"<p><p>The Venous Excess Ultrasound Score (VExUS) has produced great interest in venous Doppler ultrasound as a noninvasive means to evaluate right heart hemodynamics. While this score includes Doppler morphologies from sub-diaphragmatic veins, the physiology of transcutaneous venous Doppler velocimetry and its change with cardiac pathology was first studied and described in the internal jugular vein (IJV). Over 50 years ago, the systolic and diastolic velocity waves of the IJV were found to describe the x'- and y-descents of the jugular venous pulse (JVP) in sickness and in health. Therefore, it is established that abnormalities in right heart filling and function are reflected in the jugular venous flow velocity (JVFV) profile. In this narrative review, we highlight the physiology of the JVP, its relationship to right heart performance, and, accordingly, its connection with JVFV. Grounded upon decades-old, pioneering investigations, we briefly highlight JVFV in patients with post-cardiopulmonary bypass physiology, atrial fibrillation, pericardial tamponade, and pulmonary hypertension. We then describe a novel, wireless, and wearable Doppler ultrasound that continuously displays JVFV and consider how this device informs diagnosis and therapy of acute circulatory dysfunction. We touch on gaps in knowledge and suggest future avenues of inquiry with special attention paid to synchronous acquisition and interpretation of venous and arterial Doppler measures. We emphasize the clinical relevance of this technology and physiological framework, including acute, inpatient shock resuscitation, volume removal (eg, \"de-resuscitation\"), and the possibility for chronic, outpatient monitoring.</p>","PeriodicalId":94361,"journal":{"name":"Therapeutic advances in pulmonary and critical care medicine","volume":"20 ","pages":"29768675251359700"},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Interventional Pulmonology.","authors":"David Brower, Sohawm Sengupta, Arjun N Bhatt, Steven Allen, Rabih Bechara, Shaheen Islam, William J Healy","doi":"10.1177/29768675251353390","DOIUrl":"10.1177/29768675251353390","url":null,"abstract":"<p><p>Artificial intelligence (AI) is an exciting new technology poised to drastically improve the practice of medicine. Interventional pulmonology (IP) is particularly well situated to implement AI due to the variety of complex diagnostic and therapeutic techniques within its scope. By integrating AI into the field, the procedure planning and management of pulmonary disease should become easier, more accessible, and more effective. AI has already been implemented in the diagnostic techniques of navigational and virtual bronchoscopy, endobronchial ultrasound, and for the rapid onsite evaluation of pathological specimens. The goal of this review is to summarize recent utilization of AI in IP and to discuss the origins of the technology, ethical considerations, and future directions.</p>","PeriodicalId":94361,"journal":{"name":"Therapeutic advances in pulmonary and critical care medicine","volume":"20 ","pages":"29768675251353390"},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventilator-Associated Pneumonia: An Update on the Role of Lung Ultrasound in Adult, Pediatric, and Neonatal ICU Practice.","authors":"Diana Adrião, Francesco Mojoli, Rebeca Gregorio Hernandez, Daniele De Luca, Belaid Bouhemad, Silvia Mongodi","doi":"10.1177/29768675251349632","DOIUrl":"10.1177/29768675251349632","url":null,"abstract":"<p><p>Ventilator-associated pneumonia (VAP) remains one of the most common and challenging intensive care unit (ICU)-acquired infections, significantly contributing to mortality, morbidity, and healthcare costs. The diagnosis relies on quantitative analysis of a deep microbiological sample; a combination of clinical and radiological signs is commonly used to raise VAP suspicion in clinical practice. Traditional imaging methods such as chest radiography and computed tomography have limitations in critically ill patients under mechanical ventilation. Lung ultrasound (LUS) has emerged in the last years as a valuable tool in the assessment and monitoring of critically ill patients, including for diagnosis and management of VAP, due to its noninvasive bedside applicability and absence of radiation exposure. This last quality is of particular interest in the specific population of children and newborns, where radiation exposure should be further avoided. LUS allows for daily monitoring of lung aeration and provides a quantitative assessment through the LUS aeration score; an unexpected increase of LUS aeration score may raise the suspicion of superinfection. Key ultrasonographic findings, such as subpleural consolidations and consolidations with dynamic linear-arborescent air bronchogram, improve diagnostic specificity for VAP. Similarly to what happens with traditional radiology, the Ventilator-associated Pneumonia Lung Ultrasound Score (VPLUS) combines ultrasound signs with clinical parameters like purulent secretions to enhance diagnostic accuracy. Furthermore, LUS aeration score plays a crucial role in monitoring the response to treatment, enabling assessment of lung reaeration over time. It helps differentiate between treatment responders and nonresponders, guiding therapy adjustments and identifying complications. This review highlights the evolving role of LUS in the early diagnosis, monitoring, and treatment of VAP across various ICU settings, including its application in adult, pediatric, and neonatal care.</p>","PeriodicalId":94361,"journal":{"name":"Therapeutic advances in pulmonary and critical care medicine","volume":"20 ","pages":"29768675251349632"},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarkers in Cardiac Arrest: A Narrative Review.","authors":"Rohin Singla, Chelsey Sidaras, Jignesh K Patel","doi":"10.1177/29768675251346014","DOIUrl":"10.1177/29768675251346014","url":null,"abstract":"<p><p>Inflammatory, neurologic, and cardiac biomarkers appear to have varying significance in the prognostication of patients with cardiac arrest. Post-cardiac arrest syndrome is a condition characterized by systemic ischemia with reperfusion injury, neurologic damage, and myocardial dysfunction. The relative significance of these biomarkers remains unclear and is an area of active investigation. In this narrative review, we aim to describe what is currently known about the role of inflammatory, neurologic, and cardiac biomarkers in cardiac arrest. A PubMed review was performed for relevant articles. Articles that studied inflammatory, neurologic, and cardiac biomarkers in adult cardiac arrest were included. This narrative review determined that biomarkers play a key role in facilitating prognostication of patients with cardiac arrest. The release of inflammatory, neurologic, and cardiac biomarkers mediates inflammation, ischemic brain injury, and myocardial dysfunction. Inflammatory and neurologic biomarkers appear to have more clinical utility than cardiac biomarkers. When combined with physical exam, imaging and electroencephalograph findings, blood biomarkers can be useful in making predictions of patient outcomes post-cardiac arrest. Despite this utility, no single biomarker has sufficient power to predict patient outcomes independently. Ongoing research investigating these biomarkers remains an area of strong clinical interest. In conclusion, inflammatory, neurologic, and cardiac biomarkers all play a role in understanding both the short-term and long-term outcomes in patients with cardiac arrest. To date, no single parameter has been shown to reliably predict outcome in cardiac arrest patients. Such biomarkers remain an area of active investigation.</p>","PeriodicalId":94361,"journal":{"name":"Therapeutic advances in pulmonary and critical care medicine","volume":"20 ","pages":"29768675251346014"},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Dynamic Cause of Cardiogenic Shock Identified on Point-of-Care Ultrasound: A Case Report.","authors":"Akhilesh Gonuguntla, Thomas M Ruli, David N Maynard, Steven Fox","doi":"10.1177/29768675251344037","DOIUrl":"10.1177/29768675251344037","url":null,"abstract":"<p><p>Dynamic left ventricular outflow tract obstruction (dLVOTO) is an important cause of cardiogenic shock to consider as its management differs from garden-variety cardiogenic shock from systolic dysfunction. It is best suited for serial evaluation by point-of-care ultrasound (POCUS) as its dynamic nature may cause it to be missed on routine echocardiograms. We present a case of a 95-year-old male who presented for constipation and went into cardiac arrest after manual disimpaction. After intubation and advanced cardiovascular life support with eventual return of spontaneous circulation, the patient developed cardiogenic shock. He developed persistent lactic acidosis, increasing ventilator requirements, and worsening renal function despite diuresis and escalating epinephrine and norepinephrine requirements. POCUS revealed left ventricular systolic dysfunction with apical hypokinesis and basal hyperkinesis suspicious for stress-induced cardiomyopathy. Moreover, systolic anterior motion of the mitral valve on M-mode ultrasound and a left ventricular outflow tract pressure gradient of 46 mm Hg on spectral Doppler were noted, consistent with dLVOTO. On recognition of dLVOTO, epinephrine and norepinephrine were weaned after adding vasopressin and phenylephrine. The patient's clinical status drastically improved thereafter and he was weaned off vasopressors and the ventilator within 48 hours. POCUS techniques that are often excluded from basic critical care ultrasound exams are required to identify the characteristic features of hemodynamically significant dLVOTO. These features are important to recognize in cardiogenic shock as inotropes and diuresis can lead to paradoxical worsening of the dLVOTO. Instead, these patients should be managed with pure vasopressors and measures to increase left ventricular preload (beta blockers and intravenous fluids).</p>","PeriodicalId":94361,"journal":{"name":"Therapeutic advances in pulmonary and critical care medicine","volume":"20 ","pages":"29768675251344037"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Point-of-Care Ultrasound Evaluation of Diaphragm as a Predictor of Extubation Success in Mechanically Ventilated, Malnourished, End-Stage Liver Disease Pretransplant Candidates-Observational Cohort Study.","authors":"Adam Muhammad Reid, Sarathi Bhattacharyya, Zian Zhuang, Nida Qadir, Amy Schnabel, Alan Chiem, Semi Yoon, George Lim, Igor Barjaktarevic","doi":"10.1177/29768675251337833","DOIUrl":"10.1177/29768675251337833","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound evaluation of diaphragmatic anatomy and function has recently gained traction as a simple and useful tool to assess the extubation readiness in mechanically ventilated patients, nevertheless, how applicable this approach is in the population of chronically debilitated patients on mechanical ventilation (MV) remains unclear.</p><p><strong>Objective: </strong>To evaluate ultrasonographic assessment of diaphragmatic thickening fraction (ΔTDI%) as a predictor of extubation success in the population of end-stage liver disease (ESLD) malnourished patients on MV.</p><p><strong>Design: </strong>Prospective, single-center, observational cohort study.</p><p><strong>Methods: </strong>We used point-of-care ultrasound to evaluate ΔTDI% and diaphragm thickness during expiration (<i>T</i> _exp) and inspiration (<i>T</i> _insp) as predictors of extubation success in ESLD patients undergoing weaning from mechanical ventilation. The primary end-point was extubation tolerance (ET) assessed at 48 h.</p><p><strong>Results: </strong>Of 70 enrolled patients, 82.4% (<i>N</i> = 56) tolerated extubation. While there was no difference in ΔTDI% between those who failed extubation (EF) compared to ET at 48 h (21.2% vs 20.1%, <i>P</i> = .64), diaphragms were thicker at expiration in ET patients (<i>T</i> _exp 29.5 ± 8.1 vs 24.8 ± 5.2 mm, <i>P</i> = .047). Commonly used clinical weaning parameters, including rapid-shallow breathing index (RSBI) and negative inspiratory force (NIF) correlated better with diaphragm thickening fraction ΔTDI% than diaphragm thickness indices but were inferior predictors of extubation success compared to <i>T</i> _exp..</p><p><strong>Conclusion: </strong>Point-of-care ultrasonographic assessment of the diaphragm offers insight into the function of respiratory muscles and the limited ability to predict extubation success. Further research is necessary to better understand its potential use in MV liberation in patients with ESLD and malnutrition.</p>","PeriodicalId":94361,"journal":{"name":"Therapeutic advances in pulmonary and critical care medicine","volume":"20 ","pages":"29768675251337833"},"PeriodicalIF":3.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Adherence to the 2023 Canadian Thoracic Society Chronic Obstructive Pulmonary Disease Pharmacotherapy Guidelines: A Hospital-Based Study.","authors":"Mathieu D Saint-Pierre","doi":"10.1177/29768675251336660","DOIUrl":"https://doi.org/10.1177/29768675251336660","url":null,"abstract":"<p><strong>Background: </strong>A previous study at Montfort Hospital (Ottawa, Ontario, Canada) found that only one-fifth of patients treated in 2022 for a severe acute exacerbation of chronic obstructive pulmonary disease (AECOPD) were prescribed the appropriate inhaled therapy at discharge. The revised 2023 Canadian Thoracic Society (CTS) COPD pharmacotherapy guidelines now recommend inhaled triple therapy as initial maintenance treatment in patients at high risk of AECOPD.</p><p><strong>Objectives: </strong>The primary objective of this study was to determine if adherence to the CTS guidelines significantly improved following the publication of the 2023 statement. A secondary objective was to review the proportion of patients receiving appropriate optimization based on whether they were treated exclusively in the emergency department (ED) or required hospitalization.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Methods: </strong>Subjects treated for AECOPD in the first 12 months after the publication of the 2023 guidelines were reviewed. Patient characteristics and inhaled therapy were charted. Adherence to the guidelines was compared to the prior cohort from 2022.</p><p><strong>Results: </strong>A total of 169 patients were treated for AECOPD. After excluding individuals who died in the hospital and those who were maintained on inhaled triple therapy, 74 were candidates for review of their inhaled therapy. 27% received recommended medication optimization at discharge compared to 20% in 2022 (P = 0.25). Adherence to the guidelines significantly improved for hospitalized patients (51% vs 27%, P = 0.02). Only 5% of subjects treated exclusively in the ED received appropriate inhaler optimization. The most common deviations from the guidelines were the continued use of prior therapy (35%) and the lack of any long-acting medication (22%).</p><p><strong>Conclusions: </strong>Adherence to the CTS COPD pharmacotherapy guidelines remained very low in ED-treated patients. The findings highlight the need for structured COPD care plans.</p>","PeriodicalId":94361,"journal":{"name":"Therapeutic advances in pulmonary and critical care medicine","volume":"20 ","pages":"29768675251336660"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Functional Impairment in Severe COVID-19 Patients Two Months After Discharge.","authors":"Antoine El Kik, Hind Eid, Nabil Nassim, Karim Hoyek, Albert Riachy, Bassem Habr, Ghassan Sleilaty, Moussa Riachy","doi":"10.1177/29768675241305102","DOIUrl":"10.1177/29768675241305102","url":null,"abstract":"<p><strong>Background: </strong>The Post-COVID-19 Functional Status (PCFS) scale is a validated tool used to measure the functional status of patients discharged from the hospital.</p><p><strong>Objectives: </strong>To describe the functional limitations of hospitalized COVID-19 patients at the time of discharge and two months afterward, and to identify risk factors associated with functional impairment.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Methods: </strong>A total of 540 patients were included in this monocentric study. The functional status assessment using the PCFS scale and ventilatory needs were recorded at discharge and two months later. Univariate and multivariate analyses were performed in order to identify the risk factors of a high PCFS score.</p><p><strong>Results: </strong>Two months after discharge, the PCFS grade was 0 in 60,6% of the survivors, 1 in 24.5%, 2 in 6.9%, 3 in 2.8%, and 4 in 5.3%. The identified risk factors of a high PCFS scale were: age, arterial hypertension, diabetes mellitus, immunosuppression, cardiovascular disease, high need for oxygen and high News2 score at admission, a high percentage of ground glass at chest CT scan performed at admission or during follow-up, elevated leukocytes, neutrophils, LDH, D-dimers, procalcitonin, and serum creatinine levels. During the hospital stay, treatment with steroids, tocilizumab, longer duration of hospitalization, ICU admission and prolonged stay, and the occurrence of thromboembolic or hemorrhagic events were also significantly associated with a higher PCFS. Multivariate analysis identified that only age and a high News2 score at admission were independent risk factors of a low PCFS score.</p><p><strong>Conclusion: </strong>Multiple risk factors for a higher PCFS score were identified, but only age and a high News2 score at admission were found to be independent risk factors.</p>","PeriodicalId":94361,"journal":{"name":"Therapeutic advances in pulmonary and critical care medicine","volume":"19 ","pages":"29768675241305102"},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142879301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Narrative Review of Invasive Candidiasis in the Intensive Care Unit.","authors":"Elnè Noppè, Julian Robert Paul Eloff, Sean Keane, Ignacio Martin-Loeches","doi":"10.1177/29768675241304684","DOIUrl":"10.1177/29768675241304684","url":null,"abstract":"<p><p><i>Candida</i> species is the most common cause of invasive fungal infection in the critically ill population admitted to the intensive care unit (ICU). Numerous risk factors for developing invasive candidiasis (IC) have been identified, and some, like the breach of protective barriers, abound within the ICU. Given that IC carries a significant mortality, morbidity, and healthcare cost burden, early diagnosis and treatment have become an essential topic of discussion. Several expert panels and task forces have been established to provide clear guidance on the management of IC. Unfortunately, IC remains a diagnostic and therapeutic challenge attributable to the changing fungal ecology of <i>Candida</i> species and the emergence of multidrug-resistant strains. This narrative review will focus on the following: (1) the incidence, outcomes, and changing epidemiology of IC globally; (2) the risk factors for developing IC; (3) IC risk stratification tools and their appropriate use; (4) diagnosis of IC; and (5) therapeutic agents and regimens.</p>","PeriodicalId":94361,"journal":{"name":"Therapeutic advances in pulmonary and critical care medicine","volume":"19 ","pages":"29768675241304684"},"PeriodicalIF":0.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}