Oncological Emergencies for Intensive Care Patients
Mohammed Hossam El-Din Mahmoud;
Abstract
Over the last 15 years, the management of critically ill cancer patients requiring intensive care unit (ICU) admission has substantially changed. High mortality rates (75-85%) were reported 10-20 years ago in cancer patients requiring life sustaining treatments, especially when mechanical ventilation was needed or in recipients of hematological stem cell transplantation.
Because of these high mortality rates, the high costs and the moral burden for patients and their families, ICU admission of cancer patients became controversial or even clearly discouraged by some authors. However, prognosis of critically ill cancer patients has been improved over the past 10 years leading to an urgent need to reappraise this reluctance.
In the last decade a primary role of supportive care for improving the quality of life in oncological patients has been definitely delineated. In particular, in addition to prevention and control of undesirable side effects of antitumor treatments (i.e. nausea, vomiting, diarrhea, infection, hyperthermia, deterioration in nutritional status, pain) a careful evaluation of patient psychosocial aspects has now been routinely included in supportive care programs.
Oncologic emergencies can occur at any time during the course of a malignancy, from the presenting symptom to end-stage disease such as hypercalcemia, hyponatremia, hypoglycemia, tumor lysis syndrome, cardiac tamponade, superior vena cava syndrome, neutropenic fever, spinal cord compression, increased intracranial pressure, seizures, hyperviscosity syndrome, leukostasis, airway obstruction in patients with malignancies and Chemotherapeutic emergencies.
Oncologic emergencies can threaten the well-being of almost any patient with a malignancy. Because these conditions span the chronologic spectrum of a disease’s natural history, from initial presentation to late recurrence to end-stage disease, all clinicians should be familiar with the manner in which these conditions emerge, as well as understand the methods for their prompt assessment and treatment. Prompt identification and intervention in these emergencies can prolong survival and improve quality of life, even in the setting of terminal illness.
Because of these high mortality rates, the high costs and the moral burden for patients and their families, ICU admission of cancer patients became controversial or even clearly discouraged by some authors. However, prognosis of critically ill cancer patients has been improved over the past 10 years leading to an urgent need to reappraise this reluctance.
In the last decade a primary role of supportive care for improving the quality of life in oncological patients has been definitely delineated. In particular, in addition to prevention and control of undesirable side effects of antitumor treatments (i.e. nausea, vomiting, diarrhea, infection, hyperthermia, deterioration in nutritional status, pain) a careful evaluation of patient psychosocial aspects has now been routinely included in supportive care programs.
Oncologic emergencies can occur at any time during the course of a malignancy, from the presenting symptom to end-stage disease such as hypercalcemia, hyponatremia, hypoglycemia, tumor lysis syndrome, cardiac tamponade, superior vena cava syndrome, neutropenic fever, spinal cord compression, increased intracranial pressure, seizures, hyperviscosity syndrome, leukostasis, airway obstruction in patients with malignancies and Chemotherapeutic emergencies.
Oncologic emergencies can threaten the well-being of almost any patient with a malignancy. Because these conditions span the chronologic spectrum of a disease’s natural history, from initial presentation to late recurrence to end-stage disease, all clinicians should be familiar with the manner in which these conditions emerge, as well as understand the methods for their prompt assessment and treatment. Prompt identification and intervention in these emergencies can prolong survival and improve quality of life, even in the setting of terminal illness.
Other data
| Title | Oncological Emergencies for Intensive Care Patients | Other Titles | طوارئ الأورام السرطانية لمرضي الرعايه المركزة | Authors | Mohammed Hossam El-Din Mahmoud | Issue Date | 2017 |
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