Endocarditis in the intensive care unit: an update

Purpose of review The incidence of infective endocarditis (IE) is increasing worldwide, resulting in a higher number of patients with IE being admitted to intensive care units (ICU). Nearly half of patients with IE develop a complication during their clinical course. However, few well conducted studies or reviews are devoted to critically ill IE patients. This review discusses the contemporary perioperative and intensive care literature. Recent findings IE epidemiology is changing towards elderly and frail patients. ICU patients are at risk of risk of developing IE because they are often in a pro-inflammatory state and many also have several indwelling catheters, which favors infection. Increased performance and recent advances in cardiac imaging allow for easier diagnosis of EI, but the applicability of these techniques to ICU patients is still relatively limited. New developments in antibiotic treatment and adjunctive therapies are explored further in this review. The lack of evidence on ICU patients with IE highlights the critical importance of multidisciplinary decision-making and the need for further research.

Automated summary

This review focuses on critically ill infective endocarditis (IE) patients during perioperative and intensive care, and highlights the changing epidemiology of IE towards elderly and frail patients. ICU patients are at a higher risk of developing IE due to their pro-inflammatory state and indwelling catheters. Although cardiac imaging techniques have improved for the diagnosis of EI, their applicability to ICU patients is still limited. The review also discusses new developments in antibiotic treatment and adjunctive therapies. The lack of evidence on ICU patients with IE emphasizes the critical importance of multidisciplinary decision-making and further research.