Managing febrile neutropenia in adult cancer patients: an integrative review of the literature

Abstract

Objective: To analyze the interventions performed by health professionals with a view to managing chemotherapy-induced febrile neutropenia. Method: Integrative literature review, the sample of 12 primary articles was selected from the following databases: LILACS, SciELO, BVS, PubMed, CINAHL and Web of Science. Results: There was a prevalence of studies, realized by doctors, focused on pharmacological treatment and on the association of methods for greater diagnostic accuracy of febrile neutropenia. A study was found on pharmaceutical management regarding antibiotic dosing efficacy and a study indicating that nurses could contribute to the identification of elderly patients who would benefit from prophylactic use of growth factor. Conclusion: There was a shortage of studies involving the participation of other health professionals, besides the doctors, and a knowledge gap regarding interprofessional practice in the management of interventions specific to their area of specialism, joint interventions and non-pharmacological interventions. Descriptors: Oncology; Hospital Oncology Service; Chemotherapy-Induced Febrile Neutropenia; Management; Patient Care Team. RESUMO Objetivo: Analisar as intervenções realizadas por profissionais de saúde visando ao manejo da neutropenia febril induzida por Quimioterapia. Método: Revisão integrativa da literatura cuja amostra de 12 artigos primários foi selecionada nas bases LILACS, SciELO, BVS, PubMed, CINAHL e Web of Science. Resultados: Constatou-se a prevalência de estudos, desenvolvidos por médicos, centrados no tratamento farmacológico e na associação de métodos para maior precisão diagnóstica da neutropenia febril. Encontrou-se um estudo sobre manejo farmacêutico relativo à eficácia de dosagem de antibióticos e um estudo indicando que os enfermeiros poderiam contribuir para a identificação de pacientes idosos que se beneficiariam com uso profilático de fator de crescimento. Conclusão: Evidenciou-se a escassez de estudos com a participação de outros profissionais de saúde, além dos médicos, e a lacuna de conhecimento quanto à prática interprofissional na condução de intervenções específicas a sua área de competência, intervenções conjuntas e intervenções não farmacológicas. Descritores: Oncologia; Serviço Hospitalar de Oncologia; Neutropenia Febril Induzida por Quimioterapia; Manejo; Equipe de Assistência ao Paciente. RESUMENObjetivo: Analizar las intervenciones realizadas por profesionales de salud visando el manejo de la neutropenia febril inducida por Quimioterapia. Método: Revisión integradora de la literatura cuya muestra de 12 artículos primarios fue seleccionada en las bases LILACS, SciELO, BVS, PubMed, CINAHL y Web of Science. Resultados: Se constató la prevalencia de estudios, desarrollados por médicos, centrados en el tratamiento farmacológico y en la asociación de métodos para mayor precisión diagnóstica de la neutropenia febril. Se encontró un estudio sobre manejo farmacéutico relativo a la eficacia del dosificación de antibióticos y un estudio indicando ...

Mitigating Effect of 1-Palmitoyl-2-Linoleoyl-3-Acetyl-Rac-Glycerol (PLAG) on a Murine Model of 5-Fluorouracil-Induced Hematological Toxicity

“…While PLAG did not affect the first peak of the pro-inflammatory cytokine/chemokines on day 0.5 (Figure 5E,G,I), the levels of CXCL1, CXCL2, and IL-6 were significantly and dose-dependently attenuated by PLAG on day 6 (Figure 5F,H,J). The appearance of fever in neutropenic patients, called febrile neutropenia, is a serious complication that requires immediate hospitalization [40]. Therefore, we also examined the plasma level of C-reactive protein (CRP), which is a well-known marker for febrile neutropenia [41,42].…”

<b> Avaliação do conhecimento dos enfermeiros sobre neutropenia febril em crianças com câncer/Evaluation of nurses knowledge about febrile neutropenia in children with cancer

“…A antibioticoterapia deve ser introduzida imediatamente após avaliação ágil, objetiva e completa. Em mais de 80% dos casos são as bactérias as responsáveis pelos episódios de febre nos pacientes neutropênicos, sendo estas bactérias, na maior parte das vezes, grampositivas, embora as bactérias gram-negativas também possam ocorrer (20) .…”

“…Portanto, deve-se instituir um esquema antimicrobiano de amplo espectro, cobrindo gram-positivos e gram-negativos, incluindo Pseudomonas aeruginosa. O esquema antimicrobiano escolhido deve atingir níveis séricos efetivos da droga, apresentar baixa toxicidade e simplicidade de administração (20) .…”

First Insights into Clinical and Resistance Features of Infections by Klebsiella pneumoniae among Oncological Patients from a Referral Center in Amazon Region, Brazil

“…Several factors are associated with increased risk of infections among cancer patients. Severe and prolonged neutropenia induced by chemotherapy is the main risk factor for the acquisition of serious infections, including those caused by MDR pathogens [10,11]. Moreover, immunocompromised individuals demonstrate few clinical signs in bacterial infections, which are commonly confused with the symptoms of the underlying neoplasm or treatment side effects [7,10,11].…”

“…Severe and prolonged neutropenia induced by chemotherapy is the main risk factor for the acquisition of serious infections, including those caused by MDR pathogens [10,11]. Moreover, immunocompromised individuals demonstrate few clinical signs in bacterial infections, which are commonly confused with the symptoms of the underlying neoplasm or treatment side effects [7,10,11]. Other risk factors that contribute to poor prognosis infections in cancer patients are myeloablative therapy, total body irradiation, high doses of steroids, tissue grafting, prolonged hospitalization, recent surgery, resection of multiple organs, exposed cancer, enteral diet, ostomies, admission to intensive care unit (ICUs), presence of central venous catheter, bladder catheterization, ventilatory assistance, hemodialysis and disease chronic pulmonary disease [12][13][14][15].…”