Evidence mapPaperPMID 40465080Full record

GuidelineInfection2025

Diagnosis and treatment of invasive pulmonary aspergillosis in critically ill intensive care patients: executive summary of the German national guideline (AWMF 113-005).

Dominic Wichmann, Martin Hoenigl, Philipp Koehler, Christina Koenig, Frederike Lund, Sebastian Mang, Richard Strauß, Markus A Weigand, Christian Hohmann, Oliver Kurzai and 2 more

Abstract readPractice GuidelineReview
In one paragraph

Guideline in Infection, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. Trial
  2. Article
  3. Observational
  4. Article
  5. Review
  6. Diagnostic performance ofJournal of thoracic disease · 2025
    Article
  7. Article
  8. Transcriptomic and metabolomic analysis of a non-Frontiers in microbiology · 2025
    Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Dominic WichmannDepartment of Intensive Care Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. d.wichmann@uke.de.
Martin HoeniglDivision of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Philipp KoehlerFaculty of Medicine, Department I of Internal Medicine, University of Cologne, and University Hospital Cologne, Cologne, Germany.
Christina KoenigDepartment of Intensive Care Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
Frederike LundDepartment of Anaesthesiology, University Hospital Heidelberg, Heidelberg, Germany.
Sebastian MangDepartment of Intensive Care Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
Richard StraußDepartment of Medicine 1, University Hospital Erlangen, Erlangen, Germany.
Markus A WeigandDepartment of Anaesthesiology, University Hospital Heidelberg, Heidelberg, Germany.
Christian HohmannDepartment I of Internal Medicine, Department of Intensive Care Medicine, Klinikum Bremen-Mitte, Bremen, Germany.
Oliver KurzaiInstitute for Hygiene and Microbiology, Julius-Maximilians-University Würzburg, Würzburg, Germany.
Claus HeußelDiagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
Matthias KochanekFaculty of Medicine, Department I of Internal Medicine, University of Cologne, and University Hospital Cologne, Cologne, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe executive summary of the guideline aims to provide the most relevant recommendations on the diagnosis and treatment of invasive pulmonary aspergillosis in critically ill patients in the intensive care unit.

methodsThe guideline's work included a systematic literature search, selection and assessment of the data relevant to the issues identified. Key questions included the areas of epidemiology, risk factors, diagnostics, and therapy. They were discussed analogous to a PICO scheme within the guideline committee, with subsequent working groups proposing recommendations for specific key questions, which were then again discussed and finalized by the entire guideline committee.

resultsIn addition to the classic risk factors (persistent neutropenia, allogeneic stem cell transplantation, congenital or acquired immunodeficiency, etc.), decompensated liver cirrhosis, COPD, solid tumours and viral pneumonia (influenza, COVID-19) have been established as risk factors for critically ill patients in need of intensive care. If there is no adequate improvement or even further clinical deterioration of the respiratory status in critically ill patients, the presence of IPA should be considered and appropriate diagnostic tests should be initiated. Diagnostics should include a CT scan of the chest and a broncho-alveolar lavage with culture for moulds, testing for galactomannan and PCR. Isavuconazole and voriconazole are recommended as first-line treatment, liposomal amphotericin B as an alternative, with posaconazole (PCZ) or the echinocandins (as an add-on to azole or polyene treatment) being additional options for salvage treatment.

conclusionInvasive aspergillosis in critically ill patients represents a diagnostic and therapeutic challenge. If indicated, invasive aspergillosis should be considered and appropriate diagnostic tests initiated. Isavuconazole and voriconazole are recommended as first-line treatment, liposomal amphotericin B as an alternative.

Indexed as

Antifungal AgentsCritical CareInvasive Pulmonary AspergillosisCOVID-19Critical IllnessGermanyHumansIntensive Care UnitsRisk FactorsVoriconazoleAntifungal AgentsVoriconazoleAzolesCritically ill patientsDrug interactionsGuidelineIntensive care medicineInvasive pulmonary aspergillosis

Identifiers

PMID40465080
PMCPMC12316785

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.