Critical care 2 Flashcards
5 reasons cirrhotics are at higher risk of infection
increased bowel translocation, SIBO, immunocompromised state, alterations of gut microbiome (dysbiosis), and increased risk of resistant infections
Antibiotic regimen for cirrhotic patients with GI bleeds
fluoroquinolone or ceftriaxone x 7 days
Which patients are appropriate for PRIMARY SBP ppx?
low protein ascites (<1.5 g/dL) + renal or liver impairment
should cirrhotics with asymptomatic candiduria be treated?
no (exchange Foley)
Should fungus-positive BAL or sputum cultures be treated?
no
When should positive fungal cultures from sputum or urine be treated?
when fungus is cultured from 2 or more sites
What drug should be given empirically to start fungal treatment for critically ill patients?
micafungin (or caspofungin or anidulafungin [echinocandins])
What drug class should be used as de-escalation for patients with fungal infections?
Azoles
Goal fibrinogen level for cirrhotics with active bleeding or going for surgery?
> 1.5 g/L
When should TEG be used to guide coagulation mgmt in cirrhotics?
during surgery