Efficacy and outcome of intensive care in pediatric oncologic patients

Abstract

Diagnosis of cancer does not exclude potential benefit from intensive care medicine in these children, although severe complications might affect the prognosis.

A prospective, multicentric scoring system to predict mortality in febrile neutropenic children with cancer

“…Published studies with analyses that establish a risk score for mortality are scarce and mainly are based on adult and pediatric patients without neutropenia in the setting of intensive care unit admissions, adults hospitalized in oncology units, and low mortality risk scores in an adult population. 11,13 To our knowledge, there are no publications to date concerning the analysis of mortalitybased scores in hospitalized pediatric patients with FN.…”

“…[5][6][7][8][9] However, the studies that intended to identify risk factors used different designs and definitions, hindering the development of a standardized risk profile. However, several authorities analyzed the performance of different mortality scores on adult patients with cancer, either with or without FN, who were admitted to intensive care units, [10][11][12] including the Acute Physiology and Chronic Health Evaluation, the Organ Dysfunction and Infection Score, and the Simplified Acute Physiology Score. Results varied according to the method employed.…”

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

“…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).…”

“…São inúmeras as causas que podem levar o paciente oncológico pediátrico a necessitar de suporte em uma UTIP, desde aquelas relacionadas ao tumor, até à intensidade da terapia anti-neoplásica, que, por si, pode levar a complicações graves e fatais (Keengwe et al, 1999;Gutierrez e de Camargo, 2001;Heying et al, 2001;Haase et al, 2003).…”

“…séptico com insuficiência respiratória ou cardíaca, apresentando um prognóstico sombrio (van Veen et al, 1991;Sivan et al, 1991;Hayes et al, 1998;Kengwe et al, 1999;Hallahan, 2000;Heying et al, 2001;Abraham et al, 2002;Tamburro et al, 2004) (Heying et al, 2001;Carcillo, 2003 (Pollack et al, 1990;Slater e Shann, 2004 Schneider, 2000). Ao longo dos anos, a melhoria contínua ocorreu como resultado do tratamento multidisciplinar, que consiste de QT, RT, cirurgia, apoio psicossocial, regimes de terapia intensiva, TMO e imunoterapia (Pizzo, 2006).…”