The intensive care unit in paediatric oncology.

Heney, David; Lewis, Ian; Lockwood, Liane; Cohen, AT; Bailey, Chris

doi:10.1136/adc.67.3.294

Cited by 40 publications

(54 citation statements)

References 16 publications

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“…9 The number of oncology patients requiring admission to the PICU has increased, reaching up to 40% 12 of patients during the course of their disease in both low-and high-income centres. 6,11,13,14 These children often have severe myelo-and immunosuppression and are more likely than other paediatric patients to require PICU care. 1,14 Timely recognition and early PICU admission offer opportunities to prevent and manage life-threatening complications of cancer management.…”

Section: Discussionmentioning

confidence: 99%

Appropriateness of admissions of children with cancer to intensive care facilities in a resource-limited setting

et al. 2017

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Background: The increasing intensity of treatment of paediatric malignancies has led to improved survival rates, but often necessitates intensive supportive care. The decision to admit a child to the paediatric intensive care unit (PICU) is based on the probability of both short-term and long-term survival in the context of severe resource constraints. Resource constraints in South Africa result in limited access of children with cancer to PICU facilities. Objectives: The aim of this study was to determine whether referrals by paediatric oncologists to a PICU in Johannesburg were appropriate by analysing indications for admission, underlying diagnoses, duration and costs of admissions, and overall outcomes. Methods: A retrospective review of consecutive PICU admissions over a 12-year period was performed. Data from all patients with histologically proven malignant conditions were included and analysed using descriptive statistical methods, Kaplan–Meier curves, log-rank analysis and Fisher’s exact test. Results: There were 5704 recorded admissions to PICU in the study period. Of these admissions, 120 (2.1%) were for patients with malignancies. The majority of PICU oncology admissions were for post-operative care, and the median duration of stay was 1 day (interquartile range: 1–3 days). The short-term mortality rate of oncology patients in PICU was 13.3% in comparison with 16.2% in the overall PICU population. The 4-year overall survival rate post PICU discharge was 54%. Conclusion: The documented short-term mortality rate indicates that referrals by paediatric oncologists are consistent with current PICU admission policies. Oncologists should assess the prognosis for survival before requesting admission to PICU, and, resources permitting, these patients should be accepted to PICU.

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Section: Discussionmentioning

confidence: 99%

Appropriateness of admissions of children with cancer to intensive care facilities in a resource-limited setting

et al. 2017

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“…[56][57][58][59][60][61][62][63][64] On the one hand, ICU personnel have often viewed transfer as oncologists 'passing the buck' or avoidance of delivering bad news to patients and families when further treatment became futile. On the other, oncologists have viewed such concerns as overly pessimistic and based on bias rather than clinical evidence.…”

Section: Improvement In Patient Outcomes Over Timementioning

confidence: 99%

Transfer of the hematopoietic stem cell transplant patient to the intensive care unit: does it really matter?

Naeem

Reed²,

Creger

et al. 2005

Bone Marrow Transplant

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“…Dentre os poucos trabalhos publicados, na maioria das vezes, a amostra analisada é pequena, menor que 100 (Sivan et al, 1991;Heney et al, 1992;Veen et al, 1996;Butt et al, 1998;Keengwe et al, 1999;Heying et al, 2001;Abraham et al, 2002;Haase et al, 2003;Kutko et al, 2003;Meyer et al, 2005;Pound et al, 2008;Dursun et al, 2009). Há apenas alguns estudos, incluindo dissertações que analisaram amostras maiores, que oscilaram entre 150 a 400 sujeitos (Hallahan et al, 2000;Dalton et al, 2003;Escobar et al, 2004;Fiser et al, 2005;Da Silva et al, 2008;Tamburro et al, 2008;Pancera et al, 2008).…”

Section: Discussionunclassified

“…Na década de 80, a mortalidade girava em torno de 32~75% (Butt et al, 1988;Heney et al, 1992;Sivan et al, 1991;van Veen et al, 1996), e na década de 90, de 13~34% (Keengwe et al, 1999;Hallahan et al, 2000;Heying et al, 2001;Abraham et al, 2002;Dalton et al, 2003). A partir do final da década de noventa, não se observou diferença na mortalidade entre pacientes oncológicos e não oncológicos com sepse e choque séptico (5,5%-16%) (Kutko et al, 2003;Fiser et al, 2005;Pound et al, 2008).…”

Section: Discussionunclassified

“…para aqueles que necessitam de suporte ventilatório ou inotrópico no contexto da sepse ou após o TMO (Butt et al, 1988;Sivan, 1991;Meert et al, 1991;Heney et al, 1992;Abraham et al 2002). Butt et al (1988) descreveram uma taxa de mortalidade de 75% para pacientes com falência respiratória ou circulatória e > 85% quando o suporte respiratório ou inotrópico foi necessário.…”

Section: Revisão Da Literatura 18unclassified

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Comparação dos diferentes escores de gravidade utilizados em unidade de terapia intensiva pediátrica oncológica

Hayashi¹

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The intensive care unit in paediatric oncology.

Cited by 40 publications

References 16 publications

Appropriateness of admissions of children with cancer to intensive care facilities in a resource-limited setting

Appropriateness of admissions of children with cancer to intensive care facilities in a resource-limited setting

Transfer of the hematopoietic stem cell transplant patient to the intensive care unit: does it really matter?

Comparação dos diferentes escores de gravidade utilizados em unidade de terapia intensiva pediátrica oncológica

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