ISCCM Position Statement on the Approach to and Management of Critically Ill Patients with Tuberculosis

Abstract

Tuberculosis (TB) is an important cause of morbidity and mortality globally. About 3–4% of hospitalized TB patients require admission to the intensive care unit (ICU); the mortality in these patients is around 50–60%. There is limited literature on the evaluation and management of patients with TB who required ICU admission. The Indian Society of Critical Care Medicine (ISCCM) constituted a working group to develop a position paper that provides recommendations on the various aspects of TB in the ICU setting based on available evidence. Seven domains were identified including the categorization of TB in the critically ill, diagnostic workup, drug therapy, TB in the immunocompromised host, organ support, infection control, and post-TB sequelae. Forty-one questions pertaining to these domains were identified and evidence-based position statements were generated, where available, keeping in focus the critical care aspects. Where evidence was not available, the recommendations were based on consensus. This position paper guides the approach to and management of critically ill patients with TB.