Abstract

Sepsis is a major cause of mortality during the neutropenic phase after intensive cytotoxic therapies for malignancies. Improved management of sepsis during neutropenia may reduce the mortality of cancer therapies. Clinical guidelines on sepsis treatment have been published by others. However, optimal management may differ between neutropenic and non-neutropenic patients. Our aim is to give evidence-based recommendations for haematologist, oncologists and intensive care physicians on how to manage adult patients with neutropenia and sepsis.

Highlights

  • Sepsis is a major cause of mortality during the neutropenic phase after intensive cytotoxic therapies for malignancies

  • The manuscript draft was peer reviewed by the review committee of the Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology (AGIHO) on October 1st, 2013

  • We suggest using the diagnostic consensus criteria for sepsis adapted to neutropenic patients (Table 2) [97, 98]

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Summary

REVIEW ARTICLE

Management of sepsis in neutropenic patients: 2014 updated guidelines from the Infectious Diseases Working Party of the German Society of Hematology and Medical Oncology (AGIHO). Olaf Penack & Carolin Becker & Dieter Buchheidt & Maximilian Christopeit & Michael Kiehl & Marie von Lilienfeld-Toal & Marcus Hentrich & Marc Reinwald & Hans Salwender & Enrico Schalk & Martin Schmidt-Hieber & Thomas Weber & Helmut Ostermann. Received: 17 March 2014 / Accepted: 9 April 2014 / Published online: 29 April 2014 # The Author(s) 2014. This article is published with open access at Springerlink.com

Clinical significance and methods
Good evidence to support a recommendation against use Quality of evidence
Def initions
Septic shock
Risk factors for bacteraemia
Risk factors for development of severe sepsis
Antimicrobial treatment
Origin Frequent pathogens
CVC central venous catheter
Treatment of cardiovascular insufficiency
Treatment of pulmonary failure
Management of renal dysfunction
Caloric intake
Treatment with coagulation inhibitors
Treatment with corticosteroids
The drug of choice to elevate the vasotonus is BII norepinephrine
Enteral nutrition is preferred over parenteral nutrition
Transfusion management
Granulocyte transfusions
Transfusion management in sepsis
Findings
Summary of recommendations

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