Vijay Kumar Mishra

Intrahospital transport (IHT) of critically ill patients is essential for diagnostic and therapeutic indications, requiring thorough assessment and careful preparation of patients, staff, and equipment throughout the process. Variability in practices among hospitals can affect patient safety and may result in adverse events (AEs). This position statement is designed to provide guidance to multidisciplinary critical care teams in the adoption of evidence-based recommendations aimed at mitigating risks and improving safety during patient transport. This position statement has been drafted by an expert committee on IHT constituted by the Indian Society of Critical Care Medicine. The process involved thorough review of literature from electronic database using PubMed services. Recommendations made are tailored with considerations for Indian setting; the units may further modify these as per local needs and equipment and staffing available. The final manuscript was written after achieving consensus among members, and final draft was accepted by all the committee members. This position statement offers a compilation of 38 strategic recommendations, which are comprehensive and deal with all aspects of IHT of the critically ill. Recommendations provided in this document are, therefore, applicable for routine use during the IHT. They cover all phases of transport and answer questions pertaining to pre-, intra-, and post-transport considerations. It will help to achieve uniformity, minimize AEs, and enhance safety. This is a standard set of 38 evidence-based recommendations to ensure safety for IHT, tailored for implementation in various criticalcare settings across India. Science is ever-changing, and periodic review will be needed to keep it up to date with emerging evidence and standards. Zirpe KG, Tiwari AM, Kulkarni AP, Govil D, Samavedam S, Sharma J, et al. Position Statement of ISCCM on Intrahospital Transport of Critically Ill Patients. Indian J Crit Care Med 2025;29(4):291–300.

Invasive fungal infections (IFI) in the intensive care unit (ICU) are an emerging problem owing to the use of broad-spectrum antibiotics, immunosuppressive agents, and frequency of indwelling catheters. Timely diagnosis which is imperative to improve outcomes can be challenging. This position statement is aimed at understanding risk factors, providing a rational diagnostic approach, and guiding clinicians to optimize antifungal therapy. To update evidence on epidemiology, risk factors, diagnostic approach, antifungal initiation strategy, therapeutic interventions including site-specific infections and role of therapeutic drug monitoring in IFI in ICU and focus on some practice points relevant to these domains. A committee comprising critical care specialists across the country was formed and specific aspects of fungal infections and antifungal treatment were assigned to each member. They extensively reviewed the literature including the electronic databases and the international guidelines and cross-references. The information was shared and discussed over several meetings and position statements were framed to ensure their reliability and relevance in critical practice. The draft document was prepared after obtaining inputs and consensus from all the members and was reviewed by an expert in this field. The existing evidence on the management of IFI was updated and practice points were prepared under each subheading to enable critical care practitioners to streamline diagnosis and treatment strategies for patients in the ICU with additional detail on site-specific infections therapeutic drug monitoring. This position statement attempts to address the management of IFI in immunocompetent and non-neutropenic ICU patients. The practice points should guide in optimization of the management of critically ill patients with suspected or proven fungal infections. Bhattacharya PK, Chakrabarti A, Sinha S, Pande R, Gupta S, Kumar AAK, et al. ISCCM Position Statement on the Management of Invasive Fungal Infections in the Intensive Care Unit. Indian J Crit Care Med 2024;28(S2):S20-S41.