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Course Image Immunocompromised patients Part I

Immunocompromised patients Part I

Part 1: Recognizing the Immunocompromised Patient in the ICU

ACE
Systemic Inflammation and Sepsis

Summary

Many patients in the Intensive Care Unit (ICU) are immunocompromised. In some, immunosuppression is easily apparent, especially when caused directly by underlying disease (such as hematological malignancies) or treatment (such as drugs to prevent organ rejection or as a side effect of cancer chemotherapy). In others, immunosuppression is less apparent and is induced by the underlying disease, for example following traumatic injury or sepsis, or as a response to therapies provided during intensive care (such as steroids).

Note: Infection remains an important cause of morbidity and mortality in immunocompromised patients.

While immunosuppression itself does not cause pathology, it does leave the patient more prone to infection. The clinician must maintain a high index of suspicion as there is currently no good test to measure the degree of immunosuppression. The consequences of immune suppression in the ICU highlight the importance of infection prevention and control, as well as surveillance measures to ensure that appropriate treatment is implemented safely and quickly. Intensive care clinicians require a thorough understanding of the mechanisms of immune suppression and the management of patients with immune dysfunction.



General Information

Enrolled trainees 1776

Open 23.08.2019

Available for ESICM members

Student effort 1

Last Updated April 19, 2024

Intended Learning Outcomes

After studying this module on Recognizing the Immunocompromised Patient you should be able to:

  • Define an approach to the identification of an immunocompromised patient
  • Appreciate the utility (and limitations) of imaging, microbiological, and serologic testing for diagnosing infection in the immunocompromised patient
  • Understand the promise, and present limitations, of new biochemical markers of infection and molecular diagnostic techniques for diagnosing infection in this patient population

Relevant competencies in CoBaTrICE

  • 1.1 Adopts a structured and timely approach to the recognition, assessment and stabilisation of the acutely ill patient with disordered physiology 
  • 2.2 Undertakes timely and appropriate investigations 
  • 2.10 Integrates clinical findings with laboratory investigations to form a differential diagnosis 
  • 11.6 Critically appraises and applies guidelines, protocols and care bundles 

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