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Hematological issues in critically ill patients with cancer
Karen S Carlson1, Maria T DeSancho
1Department of Medicine, New York Presbyterian Hospital of Weill Cornell Medical College, 525 E 68th Street, Payson 3, New York, NY 10065, USA.
Critical Care Clinics
|December 1, 2009
Summary
Critically ill cancer patients in the intensive care unit (ICU) often experience bleeding or clotting issues due to cancer and its treatments. This review covers hemostasis, complications, and management strategies for these complex cases.
Area of Science:
- Oncology
- Hematology
- Intensive Care Medicine
- Hemostasis and Thrombosis
Background:
- Cancer patients, especially those in intensive care units (ICUs), frequently develop life-threatening bleeding or thrombotic complications.
- Advances in cancer care lead to more cancer patients in ICUs, increasing the likelihood of encountering hemostatic issues.
- Malignancy and its treatments significantly disrupt normal hemostasis, complicating patient management.
Purpose of the Study:
- To review the physiology of coagulation and fibrinolysis in the context of malignancy.
- To detail the pathophysiology of bleeding and thrombotic complications in critically ill cancer patients.
- To discuss diagnostic and therapeutic strategies, including novel agents.
Main Methods:
- Review of current literature on cancer-related hemostatic complications.
- Analysis of physiological aspects of coagulation and fibrinolysis altered by malignancy.
- Discussion of diagnostic and therapeutic approaches for intensivist management.
Main Results:
- Cancer profoundly affects hemostatic equilibrium, leading to complex bleeding and thrombotic risks.
- Specific pathophysiological mechanisms of these complications in cancer patients are detailed.
- New cancer therapies and anticoagulant/clotting agents impact management strategies.
Conclusions:
- Intensivists must understand altered hemostasis in cancer patients for effective diagnosis and management.
- Comprehensive knowledge of pathophysiology and available treatments is crucial for improving outcomes.
- Emphasis on novel agents and cancer therapies is vital for managing these high-risk patients.
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