Management of unstable pediatric hemato-oncology patient: results of a web-based survey to pediatric oncologists in Spain
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- 作者：Alberto García-Salido (1)
María Isabel Iglesias-Bouzas (1)
Montserrat Nieto-Moro (1)
álvaro Lassaleta-Atienza (2)
Ana Serrano-González (1)
Juan Casado-Flores (1) - 关键词：Pediatrics ; Pediatric hematology/oncology ; Intensive care ; Health care survey
- 刊名：European Journal of Pediatrics
- 出版年：2013
- 出版时间：January 2013
- 年：2013
- 卷：172
- 期：1
- 页码：51-58
- 全文大小：544KB
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María Isabel Iglesias-Bouzas (1)
Montserrat Nieto-Moro (1)
álvaro Lassaleta-Atienza (2)
Ana Serrano-González (1)
Juan Casado-Flores (1)
1. Pediatric Critical Care Unit, Hospital Infantil Universitario Ni?o Jesús, Avenida Menéndez Pelayo 65, Madrid, Spain
2. Hemato-oncology Unit, Hospital Infantil Universitario Ni?o Jesús, Madrid, Spain
文摘
The current management and monitoring of unstable pediatric hemato-oncology patient (UPHOP) in the oncology ward is not well defined. To evaluate this concept, an anonymous Web-based survey was sent to the 150 Spanish pediatric oncologists registered in the Spanish Society of Pediatric Hemato-Oncology. The response rate was 57?%, with the following main results: Pediatric intensive consulting was available for 97?%, and it was made in case of UPHOP by 37?% of oncologists, up to 65?% if hemodynamic instability. In case of inotropic support initiation, 32?% of respondents never consulted the intensivist. Dopamine is first chosen inotropic; 28?% of surveyed considered there is no limit in its dosage or it is superior to 20?μg/kg/min before an intensivist consulting. Pediatric intensive care admission was considered necessary in case of fever with hemodynamic instability by 15?% of respondents. Respiratory monitoring was mainly done by clinical signs (67?%). In case of respiratory insufficiency, the noninvasive respiratory support by high-flow ventilation with nasal cannula was applied by 57?% in the oncology ward. In case of acute kidney injury, diuretics were generally the initial therapy. The anticonvulsive drugs most frequently applied were valproic acid (93?%), diazepam (88?%), and phenytoin (81?%). Conclusion: A consensus should be achieved among oncologists and intensivists. The creation and training of rapid response teams could be useful to improve the UPHOP management.