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Schnell D, Azoulay E, Benoit D, et al. 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). Ann Intensive Care. 2016;6(1):90doi: 10.1186/s13613-016-0189-6.
Schnell, D., Azoulay, E., Benoit, D., Clouzeau, B., Demaret, P., Ducassou, S., Frange, P., Lafaurie, M., Legrand, M., Meert, A. P., Mokart, D., Naudin, J., Pene, F., Rabbat, A., Raffoux, E., Ribaud, P., Richard, J. C., Vincent, F., Zahar, J. R., & Darmon, M. (2016). 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). Annals of intensive care, 6(1), 90. https://doi.org/10.1186/s13613-016-0189-6
Schnell, David, et al. "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)." Annals of intensive care vol. 6,1 (2016): 90. doi: https://doi.org/10.1186/s13613-016-0189-6
Schnell D, Azoulay E, Benoit D, Clouzeau B, Demaret P, Ducassou S, Frange P, Lafaurie M, Legrand M, Meert AP, Mokart D, Naudin J, Pene F, Rabbat A, Raffoux E, Ribaud P, Richard JC, Vincent F, Zahar JR, Darmon M. 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). Ann Intensive Care. 2016 Dec;6(1):90. doi: 10.1186/s13613-016-0189-6. Epub 2016 Sep 15. PMID: 27638133; PMCID: PMC5025409.
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Ann Intensive Care. 2016 Dec;6(1):90. doi: 10.1186/s13613-016-0189-6. Epub 2016 Sep 15.

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).

Annals of intensive care

David Schnell, Elie Azoulay, Dominique Benoit, Benjamin Clouzeau, Pierre Demaret, Stéphane Ducassou, Pierre Frange, Matthieu Lafaurie, Matthieu Legrand, Anne-Pascale Meert, Djamel Mokart, Jérôme Naudin, Frédéric Pene, Antoine Rabbat, Emmanuel Raffoux, Patricia Ribaud, Jean-Christophe Richard, François Vincent, Jean-Ralph Zahar, Michael Darmon

Affiliations

  1. Angouleme Hospital, Angoulême, France.
  2. Saint-Louis University Hospital, Paris, France.
  3. Intensive Care Unit, Ghent University Hospital, Ghent, Belgium.
  4. Medical Intensive Care Unit, Pellegrin University Hospital, Bordeaux, France.
  5. Paediatric Intensive Care Unit, Centre Hospitalier Chrétien, Liège, Belgium.
  6. Pediatric Hematological Unit, Bordeaux University Hospital, Bordeaux, France.
  7. Microbiology Laboratory & Pediatric Immunology - Hematology Unit, Necker University Hospital, Paris, France.
  8. Department of Infectious Diseases, Saint-Louis University Hospital, Paris, France.
  9. Surgical ICU and Burn Unit, Saint-Louis University Hospital, Paris, France.
  10. Thoracic Oncology Department and Oncologic Intensive Care Unit, Institut Jules Bordet, Brussels, Belgium.
  11. Polyvalent Intensive Care Unit, Department of Anesthesiology and Critical Care, Institut Paoli Calmette, Marseille, France.
  12. Pediatric ICU, Robert Debré University Hospital, Paris, France.
  13. Cochin University Hospital Hospital, Paris, France.
  14. Respiratory Intensive Care Unit, Cochin University Hospital Hospital, Paris, France.
  15. Department of Hematology, Saint-Louis University Hospital, Paris, France.
  16. Department of Stem Cell Transplantation, Saint-Louis University Hospital, Paris, France.
  17. Croix Rousse University Hospital, Lyon, France.
  18. Montfermeil Hospital, Montfermeil, France.
  19. Infection Control Unit, Angers University Hospital, Angers, France.
  20. University Hospital, Saint-Etienne, France. [email protected].
  21. Medical-Surgical Intensive Care Unit, Saint-Etienne University Hospital, Avenue Albert Raymond, 42270, Saint-Etienne, Saint-Priest-En-Jarez, France. [email protected].

PMID: 27638133 PMCID: PMC5025409 DOI: 10.1186/s13613-016-0189-6

Abstract

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.

Keywords: Antibiotics; Guidelines; Intensive care units; Isolation; Neutropenia; Prognosis

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