Objective: There is a paucity of research on the factors predicting mortality and a length of stay in the Intensive Care Unit (ICU) with solid tumor patients. This study will assess the characteristics and predictors of outcomes of patients with solid tumors in medical ICU. Material and Methods: This research has been designed as a retrospective observational study using an ICU database. Patients who have a solid tumor were included in the study (May 2015 to July 2018). Post-surgical and those with a length of stay of more than one day are excluded from the study. We identified the predictors     for ICU mortality and ICU long stay (≥21 days). Results: Out of 2883 patients, 364 patients with solid tumors were enrolled. The commonest sites for solid tumors were breast (15.9%), colorectal (11.5%), and lung (9.9%). 158 (43.4%) had metastatic disease, and 264 (72.5%) with progressive disease. The major reasons for ICU admission were a respiratory failure (52.7%) and severe sepsis (52.2%). The ICU and hospital mortality rates were 32.4% and 47%, respectively. Fifty patients (13.7%) had long stayed (≥ 21 days) in ICU. The independent predictors for mortality were Sequential Organ Failure Assessment (SOFA) score (OR, 1.2; 95% CI, 1.1–1.3; P=.000), invasive ventilation (OR, 3.5; 95% CI, 1.5–8.3; P=.004) and vasopressor (OR, 2.6; 95% CI, 1.1–5.9; P=.018), while the independent predictors of long-stay were ICU infections (odds ratio [OR], 18.9; 95% CI, 5.3 – 66.7; P=.0001), SOFA score (OR, 1.5; 95% CI, 1.2–1.8; P=.0001), invasive ventilation (OR, 8.2; 95% CI, 1.6–40.4; P=.009), bilirubin (OR, .5; 95% CI .2–.9; P=.049). Conclusion: Irrespective of the cancer stage, patients had a reasonable survival, and most do not require a long stay in the ICU. Flexibility in admission should be considered as disease progression and metastatic disease were not independent predictors of ICU mortality or long stay in this study.

We are presenting a very rare and unique case of postpartum hemorrhage with excessive blood loss requiring 6 units of packed red cells, 2 units of single donor platelet transfusions, 4 fresh frozen plasmas, and 4 cryoprecipitates. The patient developed a life-threatening spectrum of thrombotic microangiopathy which is known to result in pregnancy from eclampsia, pre-eclampsia, thrombotic thrombocytopenic purpura, typical and atypical hemolytic uremic syndrome, and hemolysis, elevated liver enzymes, low platelets syndrome and in non-pregnant patients with a wide differential diagnosis. The patient required 7 sessions of plasma exchange along with systemic steroids. During her illness, she developed rising liver enzymes and bilirubin, diffuse intravascular coagulation, renal failure, alveolar hemorrhage, and acute fulminant hepatic failure. A contrast-enhanced computed tomography scan revealed multiple areas of liver infarction with patent hepato-portal vessels. The patient required continuous renal replacement therapy and high supportive care. She stayed in the intensive care unit for 9 days, developed multi-organ failure, and finally expired. It is highly imperative to be aware of the complications of postpartum hemorrhage, as it should be treated promptly to minimize the possible cascade of multi-organ failure with high maternal and fetal mortality. Liver transplantation is the only possible radical therapy in cases with fulminant hepatic failure, worth considering, if clinically possible and applicable.

We are reporting a unique case of ruptured hydatid cyst which required hypertonic saline irrigation which is one of the standard forms of management in these patients. The patient developed iatrogenic acute hypernatremia reaching a level of 197 mmols, which has rarely been described in the literature. The acute rise of serum sodium drastically increases the risk of Osmotic demyelination syndrome. After correction of hypernatremia, the patient improved well, without any neurological deficit. Very few cases have been reported in adults in the literature which survived this degree of hypernatremia without complications, even after successful management, as mortality reaches up to 70 % when serum sodium reaches 160 mmols. Prevention of severe hypernatremia is the cornerstone to decrease mortality. Frequent monitoring of serum sodium level is mandatory to prevent the neurological complications.

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We are reporting a fatal case of air embolism. Although minor cases of air embolism may go unnoticed, this is a case of fatal air embolism after intravenous entry of air, which presented with sudden onset of pulseless electrical activity during a computed tomography scan in the radiology department, requiring cardiopulmonary resuscitation for 15 min. Subsequently, after admission to the intensive care unit, we achieved return of spontaneous circulation. The patient was intubated and ventilated in a shock state. He remained in refractory shock despite of supportive care. Cardiaс arrest was registered again in the catheterization lab and the patient could not be revived after 4 h from the initial cardiac arrest. А computed tomography scan was reported to reveal a significant amount of intra-cardiac air, which was the likely cause patient’s death. The case is a rare condition, which highlights the importance of early diagnosis and delivers a message to the medical staff to have a high index of suspicion in patients who have risk factors, and who develop sudden shock with hypoxemia, in order to treat this potentially life-threatening condition effectively in a timely manner.