Managing critically Ill hematology patients: Time to think differently

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• 作者：Elie Azoulay^c ; ^{elie.azoulay@sls.aphp.fr" class="auth_mail" title="E-mail the corresponding author} ; Fré ; dé ; ric Pè ; ne^a ; Michael Darmon^b ; Etienne Lengliné ; ^c ; Dominique Benoit^d ; Marcio Soares^e ; Francois Vincent^f ; Fabrice Bruneel^g ; Pierre Perez^h ; Virginie Lemiale^c ; Djamel Mokartⁱ ; Groupe de Recherche Respiratoire en Ré ; animation Onco-Hé ; matologique (Grrr-OH)¹
• 关键词：Acute respiratory failure ; Mechanical ventilation ; Outcomes ; Leukemia ; Bone marrow transplantation
• 刊名：Blood Reviews
• 出版年：2015
• 出版时间：November 2015
• 年：2015
• 卷：29
• 期：6
• 页码：359-367
• 全文大小：508 K

文摘

The number of patients living with hematological malignancies (HMs) has increased steadily over time. This is the result of intensive and effective treatments that also increase the probability of infiltrative, infectious or toxic life threatening event. Over the last two decades, the number of patients with HMs admitted to the ICU increased and their mortality has dropped sharply. ICU patients with HMs require an extensive diagnostic workup and the optimal use of ICU treatments to identify the reason for ICU admission and the nature of the complication that explains organ dysfunctions. Mortality of ARDS or septic shock is up to 50%, respectively. In this review, the authors share their experience with managing critically ill patients with HMs. They discuss the main aspects of the diagnostic and therapeutic management of critically ill patients with HMs and argue that outcomes have improved over time and that many classic determinants of mortality have become irrelevant.