Improved short- and long-term outcome of allogeneic stem cell recipients admitted to the intensive care unit: a retrospective longitudinal analysis of 942 patients

Abstract

Besides ARF and septic shock, cardiac events were especially a major reason for ICU admission. Both short- and long-term survival of critically ill HSCT patients has improved significantly in recent years, and survival of HSCT recipients discharged from hospital is not significantly affected by a former ICU stay.

Interaction of increasing ICU survival and admittance policies in patients with hematologic neoplasms: A single center experience with 304 patients

“…The authors report about an increase of ICU survival rate from 44.4% to 60.1%. 27 Our results also point to an improvement of ICU survival of elderly patients, since age showed a marginal influence on ICU survival in our first cohort in 2009-2012 and lost its significance in the second cohort in 2013-2016.…”

“…These data are comparable to recent findings of Lueck et al, who published data of a comparative retrospective longitudinal study of 942 patients after allogeneic stem cell transplant between 2000 and 2006 and between 2007 and 2013. The authors report about an increase of ICU survival rate from 44.4% to 60.1% . Our results also point to an improvement of ICU survival of elderly patients, since age showed a marginal influence on ICU survival in our first cohort in 2009‐2012 and lost its significance in the second cohort in 2013‐2016.…”

“…But considering only patients with hematologic diseases reveals similar findings as ours. Lueck and Beutel et al reported an ICU survival rate of 23% for patients with IMV in 2018 . All of these patients had received allogeneic stem cells.…”

Management of sepsis in neutropenic cancer patients: 2018 guidelines from the Infectious Diseases Working Party (AGIHO) and Intensive Care Working Party (iCHOP) of the German Society of Hematology and Medical Oncology (DGHO)

“…But especially neutropenic septic patients benefit from a timely and targeted therapy. Typically, full-code management (without limitations of ICU resources) applies to patients with curative therapeutic options and those in remission of their malignancy, as well as to patients in whom cure is not likely but the expected life span is substantial [1,106,107]. It has been suggested in an earlier consensus that an assumed prognosis of 1 year may be used as cutoff for clinical decision-making with regard to full-code status [108].…”

ECMO for immunosuppressed patients with acute respiratory distress syndrome: drawing a line in the sand

“…The first one is our ability to reasonably prognosticate this evolving heterogeneous group of patients. With advances in oncology, haematology and immunosuppressant treatments [3], intensivists are increasingly encountering immunosuppressed patients with acute respiratory distress syndrome (ARDS), often elderly and frail [4]. The second challenge is defining the upper ceiling of intensive care support, which is frequently based on a favourable prognosis from their primary underlying disease and related immunosuppression.…”