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[Oncology patients in a pediatric intensive care unit--a 7-year experience]
1Universitätsklinik und Poliklinik für Kinder und Jugendmedizin, Zentrum für Kinderheilkunde, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale. roland.hasse@medizin.uni-halle.de
Insights
Pediatric intensive care units (PICUs) are vital for children with cancer, improving survival rates. However, critical complications still pose risks, necessitating specialized care and collaboration between pediatric oncology and PICU teams.
Area of Science:
- Pediatric Intensive Care
- Pediatric Oncology
- Critical Care Medicine
Background:
- Improved survival rates in pediatric cancer patients due to advances in therapy and diagnostics.
- Increased incidence of critical complications in childhood cancer survivors necessitates intensive care expertise.
Purpose of the Study:
- To evaluate the outcomes of pediatric oncology patients admitted to a pediatric intensive care unit (PICU).
- To identify risk factors for mortality in this patient population.
Main Methods:
- Retrospective analysis of all children admitted to the PICU.
- Identification of patients with hematologic-oncologic conditions.
- Evaluation of admission reasons, interventions, and outcomes.
Main Results:
- 196 (4.8%) of 4068 PICU admissions were oncology patients.
- Most admissions were for postoperative care, monitoring, or intervention.
- 24 patients admitted for severe complications had a 58% mortality rate, significantly higher with mechanical ventilation or sepsis.
Conclusions:
- Pediatric intensive care unit support can benefit children with cancer.
- Effective management of life-threatening complications requires close collaboration between pediatric oncology and PICU teams.
- Further research is needed to optimize treatment strategies for oncology patients requiring PICU admission.
Background:
As a result of improved therapeutic and diagnostic modalities the survival rate of children with neoplastic disease has increased dramatically. The consequences of these scientific advances have led to increased malignancy-related critical complications requiring the expertise of intensive care practitioners.
Patients:
From all children admitted to the pediatric intensive care unit (PICU) of the Martin-Luther University Halle those with hematologic-oncologic condition were evaluated.
Results:
From 4068 PICU admissions 196 (4.8%) oncologic patients were identified. Most of them were admitted for postoperative care, monitoring or intervention. 24 patients were admitted because of severe disease or treatment related complications. 14 out of 24 (58%) patients died on PICU. Mortality was significant higher in a subgroup requiring mechanical ventilation or suffering from sepsis. All patients but two with multi-organ system failure (> or = 2 organs) died.
Conclusions:
Children with neoplastic disease can benefit from pediatric intensive care unit (PICU) support. Successful treatment of life-threatening complications requires a close cooperation of pediatric oncology and PICU. Further studies are necessary to improve therapeutic strategies in oncology patients requiring PICU admission.