Curative Chemotherapy for Intubated Patients. Should We.

Abstract

The management of patients with cancer, presenting an immediate life-threatening risk is a complex and controversial subject. The admission of those patients to the care unit poses a real dilemma, we are torn between the desire to go to the limits of technical possibilities especialy for young patients. Materials and methods: We report 4 cases of patients, admitted in intensive care unit for respiratory distress causes by a tumor. These patients were intubation because of hypoxemia, and then received curative chemotherapy in the intensive care unit. Discussion: A few years ago, admission to intensive care unit for oncohematology patients was unthinkable. It still is nowadays, we are torn between the desires to go to the limits of technical possibilities especialy for young patients. A study of ICU admissions for any type of lung carcinoma (80% of Non-Small Cell Bronchial Cancers) shows that of the 22,538 patients in stages III-IV, 16360 leave the hospital and 4,889 survive at 6 months. Only 11% of mechanically ventilated patients leave the hospital. In our study, one of the four patients treated with chemotherapy responded well, a ratio of 25%. Conclusion: Admission decisions of patient with neoplasia to the ICU should be made on a case-by-case basis, somewhere between the two ends of the decision-making spectrum, based on the clinical evaluation and after discussions with the oncologist and patient