Abstract:
:Advances in the management of malignancies and organ failures have led to substantial increases in survival as well as in the number of cancer patients requiring intensive care unit (ICU) admission. Although effectiveness of ICU in this group remains controversial, the heterogeneity of its population in terms of the nature and curability of their disease and the severity of critical illness and underlying conditions may explain the plethora of issues arising when considering cancer patients for ICU admission, especially from the view of limited resources and ICU beds. The most frequent reasons leading a cancer patient to ICU are postoperative, respiratory failure, infection, and sepsis. Although reasons of admission, nature and number of organ failures, type of malignancy, and therapies that have preceded ICU admission may affect outcome, reliable scoring systems or survival predictors are missing. Literature suggests that organ dysfunction should be managed at its onset, whereas aggressive ICU management should be reappraised after a few days of full support. A multidisciplinary treating team of physicians should aid in changing the goals from restorative to palliative care when there appears to be no possible benefit from any treatment. End-of life-decisions and code status should be made by consensus, based on patients' autonomy and dignity. Further interventional multicenter studies are required to assess post-ICU burden, long-term medical outcomes, and quality of life in this cohort of patients.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Kostakou E,Rovina N,Kyriakopoulou M,Koulouris NG,Koutsoukou Adoi
10.1016/j.jcrc.2014.04.007subject
Has Abstractpub_date
2014-10-01 00:00:00pages
817-22issue
5eissn
0883-9441issn
1557-8615pii
S0883-9441(14)00145-2journal_volume
29pub_type
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更新日期:2014-06-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.04.013
更新日期:2014-08-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章,评审
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更新日期:2017-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.09.025
更新日期:2016-02-01 00:00:00
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doi:10.1016/j.jcrc.2014.09.011
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pub_type: 杂志文章,评审
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