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Clinical review: Tuberculosis on the intensive care unit
Rates of tuberculosis (TB) are increasing in most west European nations. Patients with TB can be admitted to an ICU for a variety of reasons, including respiratory failure, multiorgan failure and decreased consciousness associated with central nervous system disease. TB is a treatable disease but th...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056111/ https://www.ncbi.nlm.nih.gov/pubmed/24093433 http://dx.doi.org/10.1186/cc12760 |
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author | Hagan, Guy Nathani, Nazim |
author_facet | Hagan, Guy Nathani, Nazim |
author_sort | Hagan, Guy |
collection | PubMed |
description | Rates of tuberculosis (TB) are increasing in most west European nations. Patients with TB can be admitted to an ICU for a variety of reasons, including respiratory failure, multiorgan failure and decreased consciousness associated with central nervous system disease. TB is a treatable disease but the mortality for patients admitted with TB to an ICU remains high. Management challenges exist in establishing a prompt diagnosis and administering effective treatment on the ICU with potentially poor gastric absorption and high rates of organ dysfunction and drug toxicity. In this review reasons for ICU admission, methods of achieving a confident diagnosis through direct and inferred methods, anti-tuberculosis treatment (including steroid and other adjuvant therapies) and specific management problems with particular relevance to the intensivist are discussed. The role of therapeutic drug monitoring, judicious use of alternative regimes in the context of toxicity or organ dysfunction and when to suspect paradoxical tuberculosis reactions are also covered. Diagnostic and therapeutic algorithms are proposed to guide ICU doctors in the management of this sometimes complicated disease. |
format | Online Article Text |
id | pubmed-4056111 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-40561112014-09-27 Clinical review: Tuberculosis on the intensive care unit Hagan, Guy Nathani, Nazim Crit Care Review Rates of tuberculosis (TB) are increasing in most west European nations. Patients with TB can be admitted to an ICU for a variety of reasons, including respiratory failure, multiorgan failure and decreased consciousness associated with central nervous system disease. TB is a treatable disease but the mortality for patients admitted with TB to an ICU remains high. Management challenges exist in establishing a prompt diagnosis and administering effective treatment on the ICU with potentially poor gastric absorption and high rates of organ dysfunction and drug toxicity. In this review reasons for ICU admission, methods of achieving a confident diagnosis through direct and inferred methods, anti-tuberculosis treatment (including steroid and other adjuvant therapies) and specific management problems with particular relevance to the intensivist are discussed. The role of therapeutic drug monitoring, judicious use of alternative regimes in the context of toxicity or organ dysfunction and when to suspect paradoxical tuberculosis reactions are also covered. Diagnostic and therapeutic algorithms are proposed to guide ICU doctors in the management of this sometimes complicated disease. BioMed Central 2013 2013-09-27 /pmc/articles/PMC4056111/ /pubmed/24093433 http://dx.doi.org/10.1186/cc12760 Text en Copyright © 2013 BioMed Central Ltd |
spellingShingle | Review Hagan, Guy Nathani, Nazim Clinical review: Tuberculosis on the intensive care unit |
title | Clinical review: Tuberculosis on the intensive care unit |
title_full | Clinical review: Tuberculosis on the intensive care unit |
title_fullStr | Clinical review: Tuberculosis on the intensive care unit |
title_full_unstemmed | Clinical review: Tuberculosis on the intensive care unit |
title_short | Clinical review: Tuberculosis on the intensive care unit |
title_sort | clinical review: tuberculosis on the intensive care unit |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056111/ https://www.ncbi.nlm.nih.gov/pubmed/24093433 http://dx.doi.org/10.1186/cc12760 |
work_keys_str_mv | AT haganguy clinicalreviewtuberculosisontheintensivecareunit AT nathaninazim clinicalreviewtuberculosisontheintensivecareunit |