Intensive care for cancer patients
Only a few years ago, intensive care unit (ICU) mortality of critically ill cancer patients was unacceptably high, especially in those requiring invasive mechanical ventilation. Meanwhile, evidence-based intensive care unit admission criteria, general improvements in the management of organ dysfunctions, advances in the diagnosis and treatment of specific complications, as well as new therapeutic options for cancer and infections have led to a marked improvement of outcomes. The available data suggest that ICU survivors regain favorable quality-of-life, return to a state in which the continuation of anticancer therapy is feasible, and that their long-term survival as well as their hematologic and oncologic outcome may not be different from cancer patients who were never admitted to the ICU. Thus, a general reluctance to admit critically ill cancer patients to the ICU cannot be justified anymore.
This section covers specific aspects of nonsurgical cancer patients admitted to the ICU. The acute respiratory failure (ARF) depicts by far the most common reason for an ICU admission in these patients, followed by septic complications and other partially cancer-specific conditions and emergencies.