With a tumor diagnosis in the intensive care unit

被引:0
|
作者
Beutel, Gernot [1 ]
Liebregts, Tobias [2 ]
Boell, Boris [3 ]
机构
[1] Hannover Med Sch, Klin Hamatol Hamostaseol Onkol & Stammzelltranspla, Carl Neuberg Str 1, D-30625 Hannover, Germany
[2] Univ Duisburg Essen, Univ Klinikum Essen, Klin Hamatol & Stammzelltransplantat, Essen, Germany
[3] Uniklin Koln, Klin Innere Med 1, Ctr Integrierte Onkol CIO, Internist Intensivmed Hamatol Onkol, Cologne, Germany
来源
关键词
Triage system; Organ failure in cancer patients; Stem cell transplantation; Chimeric antigen receptor T cells; Early intervention; Criteria for intensive care transfer; Intensive care prognosis; T-CELL THERAPY; CANCER-PATIENTS; DESCAR-T; OUTCOMES; ADMISSION; MULTICENTER; SURVIVAL;
D O I
10.1007/s00108-023-01583-1
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Tumor patients nowadays show significantly improved survival rates due to advancements in modern intensive care medicine, particularly in the case of organ failure. The previous reluctance towards implementing intensive medical care measures in patients with a tumorous disease is no longer justified. For successful intensive care treatment, the timing and the mode of admission along with the specific intensive care measures and underlying organ dysfunction(s) are crucial factors for the prognosis. To ensure appropriate treatment in clinical practice and to balance between overly restrictive admission criteria and overtreatment, a triage system could be beneficial. This would consider the prognosis of the underlying malignant disease, the performance status of the patient, available treatment options and a dynamic assessment of the course of the intensive medical care. Long-term results of tumor patients show that around 80% of tumor patients who have been in the intensive care unit present physical and mental health similar to those who were never admitted. Even the majority of patients who needed ongoing cancer treatment due to tumor stage did not show any differences in treatment intensity and their remission status after 6 months. A successful intensive care medicine, the individualized definition of aims, as well as adjustment of the treatment goals, require close collaboration between hematologists, oncologists, and intensive care physicians.
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页码:946 / 954
页数:8
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