Indications for admission, treatment and improved outcome of paediatric haematology/oncology patients admitted to a tertiary paediatric ICU

被引:17
作者
Owens, C. [1 ]
Mannion, D. [2 ]
O'Marcaigh, A. [1 ]
Waldron, M. [3 ]
Butler, K. [4 ]
O'Meara, A. [1 ]
机构
[1] Our Ladys Childrens Hosp, Dept Haematol Oncol, Dublin, Ireland
[2] Our Ladys Childrens Hosp, Dept Intens Care, Dublin, Ireland
[3] Our Ladys Childrens Hosp, Dept Nephrol, Dublin, Ireland
[4] Our Ladys Childrens Hosp, Dept Infect Dis, Dublin, Ireland
关键词
Paediatric; Cancer; Critical illness; Sepsis; Toxicity; ONCOLOGY PATIENTS; CHILDREN; CHEMOTHERAPY; MALIGNANCY; CHILDHOOD; MORTALITY; CANCER;
D O I
10.1007/s11845-010-0634-8
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Overall survival in paediatric cancer has improved significantly over the past 20 years. Treatment strategies have been intensified, and supportive care has made substantial advances. Historically, paediatric oncology patients admitted to an intensive care unit (ICU) have had extremely poor outcomes. We conducted a retrospective cohort study over a 3-year period in a single centre to evaluate the outcomes for this particularly vulnerable group of patients admitted to a paediatric ICU. Fifty-five patients were admitted a total of 66 times to the ICU during the study period. The mortality rate of this group was 23% compared with an overall ICU mortality rate of 5%. 11/15 patients who died had an underlying haematological malignancy. Twenty-eight percent of children with organism-identified sepsis died. While mortality rates for paediatric oncology patients admitted to a ICU have improved, they are still substantial. Those with a haematological malignancy or admitted with sepsis are most at risk.
引用
收藏
页码:85 / 89
页数:5
相关论文
共 19 条
[1]   OUTCOME OF CHILDREN WITH HEMATOLOGIC MALIGNANCY WHO ARE ADMITTED TO AN INTENSIVE-CARE UNIT [J].
BUTT, W ;
BARKER, G ;
WALKER, C ;
GILLIS, J ;
KILHAM, H ;
STEVENS, M .
CRITICAL CARE MEDICINE, 1988, 16 (08) :761-764
[2]   Multicenter outcome of pediatric oncology patients requiring intensive care [J].
Dalton, HJ ;
Slonim, AD ;
Pollack, MM .
PEDIATRIC HEMATOLOGY AND ONCOLOGY, 2003, 20 (08) :643-649
[3]   Childhood and adolescent cancer survival: A period analysis of data from the Canadian Cancer Registry [J].
Ellison, Larry F. ;
Pogany, Lisa ;
Mery, Leslie S. .
EUROPEAN JOURNAL OF CANCER, 2007, 43 (13) :1967-1975
[4]  
Goldstein Brahm, 2005, Pediatr Crit Care Med, V6, P2
[5]   Improved outcomes of children with malignancy admitted to a pediatric intensive care unit [J].
Hallahan, AR ;
Shaw, PJ ;
Rowell, G ;
O'Connell, A ;
Schell, D ;
Gillis, J .
CRITICAL CARE MEDICINE, 2000, 28 (11) :3718-3721
[6]   Paediatric oncology and intensive care treatments: changing trends [J].
Keengwe, IN ;
Stansfield, F ;
Eden, OB ;
Nelhans, ND ;
Dearlove, OR ;
Sharples, A .
ARCHIVES OF DISEASE IN CHILDHOOD, 1999, 80 (06) :553-555
[7]   Multiplex polymerase chain reaction detection enhancement of bacteremia and fungemia [J].
Louie, Richard F. ;
Tang, Zuping ;
Albertson, Timothy E. ;
Cohen, Stuart ;
Tran, Nam K. ;
Kost, Gerald J. .
CRITICAL CARE MEDICINE, 2008, 36 (05) :1487-1492
[8]   Molecular diagnosis of sepsis in neutropenic patients with haematological malignancies [J].
Mancini, Nicasio ;
Clerici, Daniela ;
Diotti, Roberta ;
Perotti, Mario ;
Ghidoli, Nadia ;
De Marco, Donata ;
Pizzorno, Beatrice ;
Emrich, Thomas ;
Burioni, Roberto ;
Ciceri, Fabio ;
Clementi, Massimo .
JOURNAL OF MEDICAL MICROBIOLOGY, 2008, 57 (05) :601-604
[9]   Treatment of high-risk neuroblastoma with intensive chemotherapy, radiotherapy, autologous bone marrow transplantation, and 13-cis-retinoic acid [J].
Matthay, KK ;
Villablanca, JG ;
Seeger, RC ;
Stram, DO ;
Harris, RE ;
Ramsay, NK ;
Swift, P ;
Shimada, H ;
Black, CT ;
Brodeur, GM ;
Gerbing, RB ;
Reynolds, CP .
NEW ENGLAND JOURNAL OF MEDICINE, 1999, 341 (16) :1165-1173
[10]  
McGregor LM, 2007, ONCOLOGY-NY, V21, P809