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The intensive care unit in paediatric oncology: 10 years experience

We report the results of a retrospective study of the intensive care outcome of 196 children admitted with malignancy at a tertiary referral institution over a period of 10 years from 1988 to 1997. A total of 165 children required 196 admissions for a median of 3 days. Their mean age was 5.82 years and there were 100 boys (51%) and 96 girls (49%). Their admission median Apache II score was 18. A total of 150 children (76.5%) survived intensive care. Nonsurvivors had a higher Apache II score than survivors (23 vs 15 respectively, P < 0.001). Patients were divided into those needing postoperative care (n = 55), patients with respiratory infection (n = 39), systemic infection (n = 30), neurological complications (n = 20), respiratory failure with no evidence of infection (n = 17), metabolic effect (n = 13), tumour mass effect (n = 9), GI bleed (n = 5), cardiac failure (n = 4), post cardiac arrest (n = 3). The overall survival, defined as those who survived 1 week after discharge from PICU, was 73.4%. Invasive monitoring including arterial and central venous pressure line were inserted in 143 (72.9%), mechanical ventilation was required for 133 (67.8%), ionotropic support for 66 (33%), pulmonary artery floatation catheter insertion and monitoring in 23 (11.7%) and renal replacement therapy for 13 (6.6%) children. The profile of diseases in children admitted in PICU appears to be changing since last report from this unit in 1992 [1]. The most common reason for admission was need for postoperative care (28%) and survival in this group was 100%. There also is a significant improvement in survival rate of patients with systemic infections (63%) needing ventilatory support and children with respiratory (with or without infection) failure (67%) [2].

References

  1. 1.

    Heney D, Lewis IJ, Lockwood L, Cohen AT, Bailey CC: The intensive care unit in paediatric oncology. Arch Dis Child 1992, 67: 294-298.

  2. 2.

    Keengwe IN, Stansfield F, Eden OB, Nelhans ND, Dearlove OR, Sharples A: Paediatric oncology and intensive care treatments: changing trends. Arch Dis Child 1999, 80: 553-555.

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Parekh, N., Cohen, A. & O'Meara, M. The intensive care unit in paediatric oncology: 10 years experience. Crit Care 5, P242 (2001). https://doi.org/10.1186/cc1307

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Keywords

  • Respiratory Failure
  • Renal Replacement Therapy
  • Central Venous Pressure
  • Systemic Infection
  • Postoperative Care