RT journal article
T1 Managing the Next Wave of Influenza and/or SARS-CoV-2 in the ICU—Practical Recommendations from an Expert Group for CAPA/IAPA Patients
A1 Peral, Jose
A1 Estella García, Angel
A1 Nuvials, Xavier
A1 Rodríguez, Alejandro
A1 Seijas, Iratxe
A1 Soriano, Cruz
A1 Suberviola, Borja
A1 Zaragoza, Rafael
A2 Cirugía
A2 Medicina
K1 influenza-associated invasive aspergillosis
K1 COVID-associated invasive aspergillosis
K1 COVID-19
K1 intensive care unit
K1 critical patients
AB The aim of this study was to establish practical recommendations for the diagnosis andtreatment of influenza-associated invasive aspergillosis (IAPA) based on the available evidenceand experience acquired in the management of patients with COVID-19-associated pulmonaryaspergillosis (CAPA). The CAPA/IAPA expert group defined 14 areas in which recommendationswould be made. To search for evidence, the PICO strategy was used for both CAPA and IAPAin PubMed, using MeSH terms in combination with free text. Based on the results, each expertdeveloped recommendations for two to three areas that they presented to the rest of the group invarious meetings in order to reach consensus. As results, the practical recommendations for themanagement of CAPA/IAPA patients have been grouped into 12 sections. These recommendationsare presented for both entities in the following situations: when to suspect fungal infection; whatdiagnostic methods are useful to diagnose these two entities; what treatment is recommended; whatto do in case of resistance; drug interactions or determination of antifungal levels; how to monitortreatment effectiveness; what action to take in the event of treatment failure; the implications ofconcomitant corticosteroid administration; indications for the combined use of antifungals; when towithdraw treatment; what to do in case of positive cultures for Aspergillus spp. in a patient with severeviral pneumonia or Aspergillus colonization; and how to position antifungal prophylaxis in thesepatients. Available evidence to support the practical management of CAPA/IAPA patients is veryscarce. Accumulated experience acquired in the management of CAPA patients can be very useful forthe management of IAPA patients. The expert group presents eminently practical recommendationsfor the management of CAPA/IAPA patients.
PB MDPI
SN 2309-608X
YR 2023
FD 2023
LK http://hdl.handle.net/10498/32034
UL http://hdl.handle.net/10498/32034
LA eng
DS Repositorio Institucional de la Universidad de Cádiz
RD 10-nov-2026