Is intensive care justified for patients with haematological malignancies?
- 1 May 1990
- journal article
- Published by Springer Science and Business Media LLC in Intensive Care Medicine
- Vol. 16 (5), 291-297
- https://doi.org/10.1007/bf01706352
Abstract
The course of 260 adults with haematological malignancies admitted to a medical intensive care unit was studied to evaluate the value of life support techniques and to research predictive factors. The overall in the medical intensive care unit (MICU) and hospital mortality rates were respectively 43% (113 patients) and 57% (148 patients). Among survivors, 64% (49 patients) were still alive after 6 months and 44% (35 patients) after 1 year. Among 34 haemodialysed patients, the MICU mortality was 67% (23 patients) and among 111 mechanically ventilated patients 85% (94 patients). Prolonged mechanical ventilation, more than seven days, was performed in 11 of the 17 survivors and did not influence long term survival. No individual predictor of mortality was found comparing survivors and non-survivors. However, SAPS, intractable sepsis and failure of more than one organ system were significantly different in non-survivors (p<0.001). Among the 20 patients requiring both mechanical ventilation and haemodialysis, only two left the MICU and both died soon thereafter. We conclude that life support therapy should be initiated in patients with haematological disorders and that prolonged mechanical ventilation is compatible with long term survival. However, the combination of mechanical ventilation and haemodialysis is always associated with a poor prognosis and therefore the use of both techniques simultaneously for one patient is questionable.Keywords
This publication has 33 references indexed in Scilit:
- Factors related to outcome in intensive careCritical Care Medicine, 1989
- Short-Term Outcome Among Patients With Leukemia and Lymphoma Admitted to a Medical Intensive Care UnitSouthern Medical Journal, 1986
- A Randomized Trial Comparing Ceftazidime Alone with Combination Antibiotic Therapy in Cancer Patients with Fever and NeutropeniaNew England Journal of Medicine, 1986
- Adult Respiratory Distress Syndrome in Patients with Severe NeutropeniaNew England Journal of Medicine, 1986
- Intensive therapy for life-threatening medical complications of haematological malignancyIntensive Care Medicine, 1986
- Therapeutic Role of Granulocyte TransfusionsClinical Infectious Diseases, 1985
- Acute respiratory failure in severe hematologic disordersCritical Care Medicine, 1984
- A COMPARISON OF INTENSIVE CARE IN THE U.S.A. AND FRANCEThe Lancet, 1982
- Estimation of confidence limits for the cumulative probability of survival in life table analysisJournal of Chronic Diseases, 1978
- Therapeutic intervention scoring systemCritical Care Medicine, 1974