Invasive pulmonary aspergillosis (IPA) is a life-threatening fungal infection of the respiratory system, caused by a specific fungus called Aspergillus species. It is already known that patients with a weakened immune system are at higher risk of developing this disease. Recently, it has also been shown that patients with viral pneumonia (such as influenza or COVID-19) and patients with liver cirrhosis who are admitted to the intensive care unit are also vulnerable to this infection. This study aims to better define the epidemiology, clinical risk factors, outcomes, and treatment of IPA in ACLF patients admitted to the ICU. By combining clinical data with histological findings from autopsies, the study seeks to improve diagnostic accuracy, risk prediction, and timely initiation of antifungal therapy.
Study Type
OBSERVATIONAL
Enrollment
450
UZ Leuven
Leuven, Belgium
IPA incidence
The incidence of proven invasive pulmonary aspergillosis (IPA) in critically ill cirrhotic patients will be assessed. Routinely used biochemical and microbiological tests (such as galactomannan and Aspergillus PCR) will be performed on blood and BAL samples stored in the biobank to identify affected patients.
Time frame: From the date of ICU admission until ICU discharge, approximately 7 days
Identifying whether ACLF is an independent risk factor for IPA in EORTC-negative critically ill patients
The occurrence of IPA will be compared between an ACLF EORTC-negative cohort and a non-ACLF cohort
Time frame: From the date of ICU admission until ICU discharge, approximately 7 days
Clinical characteristics of IPA
Baseline characteristics, organ failures, organ support, outcome parameters
Time frame: From the date of ICU admission until ICU discharge, approximately 7 days
Radiological characteristics of IPA
Chest CT
Time frame: From the date of ICU admission until ICU discharge, approximately 7 days
Mycological characteristics of IPA
Galactomannan testing, Aspergillus PCR, mycological culture
Time frame: From the date of ICU admission until ICU discharge, approximately 7 days
Impact of IPA on length of ICU stay
Time frame: From the date of ICU admission until ICU discharge, approximately 7 days
Impact of IPA on length of hospital stay
Time frame: From the date of ICU admission until hospital discharge, approximately 36 days
Impact of IPA on mortality
Time frame: From ICU admission until 90 days post-admission
Impact of IPA on liver transplant eligibility
Time frame: From the date of ICU admission until ICU discharge, approximately 7 days
Impact of IPA on liver transplant delisting
Time frame: From the date of ICU admission until ICU discharge, approximately 7 days
Histological characteristics of IPA using tissue staining
Histological characteristics of IPA in critically ill cirrhotic patients will be analyzed. Additional histological staining (e.g., Grocott stain) will be performed to detect fungal hyphae.
Time frame: Through study completion, an average of 3 years
Histological characteristics of IPA using microbiological testing
Histological characteristics of IPA in critically ill cirrhotic patients will be analyzed. Additional microbiological testing (e.g., Aspergillus PCR) will be performed to detect fungal hyphae.
Time frame: Through study completion, an average of 3 years
Correlation of pre-mortem data with post-mortem lung tissue findings
Time frame: Through study completion, an average of 3 years
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