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Infektionen bei hämatoonkologischen Patienten auf der Intensivstation

Eine interdisziplinäre Herausforderung

Infections in hemato-oncology patients in intensive care

An interdisciplinary challenge

Medizinische Klinik - Intensivmedizin und Notfallmedizin Aims and scope Submit manuscript

Zusammenfassung

Infektionen zählen zu den häufigsten Komplikationen bei Patienten mit hämatologischen Neoplasien. Aufgrund der medizinischen und demographischen Entwicklungen ist zu erwarten, dass die Anzahl von hämatoonkologischen Patienten mit schweren Infektionen, die eine Behandlung auf einer Intensivstation benötigen, zunehmen wird. Die optimale intensivmedizinische Versorgung dieser Patienten setzt umfangreiche Kenntnisse aus mehreren medizinischen Fachbereichen voraus. Der Beitrag fasst einige der wichtigsten Aspekte des intensivmedizinischen Managements von Infektionen bei hämatoonkologischen Patienten zusammen.

Abstract

Infections are among the most common complications in patients with hematologic neoplasms. Due to changes in demographics, the number of hematologic patients with severe infections who require intensive care is expected to increase. Treatment of these patients requires knowledge of multiple specialties. This review summarizes key aspects for the optimal management of infections in critical care patients with hematologic malignancies.

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Literatur

  1. Merz TM, Schär P, Bühlmann M et al (2008) Resource use and outcome in critically ill patients with hematological malignancy: a retrospective cohort study. Crit Care 12(3):R75

    Article  PubMed  Google Scholar 

  2. Larché J, Azoulay E, Fieux F et al (2003) Improved survival of critically ill cancer patients with septic shock. Intensive Care Med 29(10):1688–1695

    Article  PubMed  Google Scholar 

  3. McGrath S, Chatterjee F, Whiteley C, Ostermann M (2010) ICU and 6-month outcome of oncology patients in the intensive care unit. QJM 103(6):397–403

    Article  PubMed  CAS  Google Scholar 

  4. Massion PB, Dive AM, Doyen C et al (2002) Prognosis of hematologic malignancies does not predict intensive care unit mortality. Crit Care Med 30(10):2260–2270

    Article  PubMed  Google Scholar 

  5. Lecuyer L, Chevret S, Thiery G et al (2007) The ICU trial: a new admission policy for cancer patients requiring mechanical ventilation. Crit Care Med 35(3):808–814

    Article  PubMed  Google Scholar 

  6. Adda M, Coquet I, Darmon M et al (2008) Predictors of noninvasive ventilation failure in patients with hematologic malignancy and acute respiratory failure. Crit Care Med 36(10):2766–2772

    Article  PubMed  Google Scholar 

  7. Ullmann AJ, Akova M, Herbrecht R et al (2012) ESCMID* guideline for the diagnosis and management of Candida diseases 2012: adults with haematological malignancies and after haematopoietic stem cell transplantation (HCT). Clin Microbiol Infect 18:53–67

    Article  PubMed  CAS  Google Scholar 

  8. Cornely OA, Maertens J, Winston DJ et al (2007) Posaconazole vs. fluconazole or itraconazole prophylaxis in patients with neutropenia. N Engl J Med 356(4):348–359

    Article  PubMed  CAS  Google Scholar 

  9. Ullmann AJ, Lipton JH, Vesole DH et al (2007) Posaconazole or fluconazole for prophylaxis in severe graft-versus-host disease. N Engl J Med 356(4):335–347

    Article  PubMed  CAS  Google Scholar 

  10. Sandherr M, Einsele H, Hebart H et al (2006) Antiviral prophylaxis in patients with haematological malignancies and solid tumours: guidelines of the infectious diseases working party (AGIHO) of the German Society for Hematology and Oncology (DGHO). Ann Oncol 17(7):1051–1059

    Article  PubMed  CAS  Google Scholar 

  11. Kumar A, Roberts D, Wood KE et al (2006) Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 34(6):1589–1596

    Article  PubMed  Google Scholar 

  12. Reinhart K, Meisner M (2011) Biomarkers in the critically ill patient: procalcitonin. Crit Care Clin 27(2):253–263

    Article  PubMed  CAS  Google Scholar 

  13. Miceli MH, Lee SA (2011) Emerging moulds: epidemiological trends and antifungal resistance. Mycoses 54(6):e666–e678

    Article  PubMed  Google Scholar 

  14. Rüping MJGT, Heinz WJ, Kindo AJ et al (2010) Forty-one recent cases of invasive zygomycosis from a global clinical registry. J Antimicrob Chemother 65(2):296–302

    Article  PubMed  Google Scholar 

  15. Mackey MC (2012) Intravesicular cidofovir for the treatment of polyomavirus-associated hemorrhagic cystitis. Ann Pharmacother 46(3):442–446

    Article  PubMed  Google Scholar 

  16. Matthes-Martin S, Feuchtinger T, Shaw PJ et al (2012) European guidelines for diagnosis and treatment of adenovirus infection in leukemia and stem cell transplantation: summary of ECIL-4 (2011). Transpl Infect Dis 14(6):555–563

    Article  PubMed  CAS  Google Scholar 

  17. Williams MD, Braun LA, Cooper LM et al (2004) Hospitalized cancer patients with severe sepsis: analysis of incidence, mortality, and associated costs of care. Crit Care 8(5):R291–R298

    Article  PubMed  Google Scholar 

  18. Soubani AO (2006) Critical care considerations of hematopoietic stem cell transplantation. Crit Care Med 34(9 Suppl):S251–S267

    Article  PubMed  Google Scholar 

  19. Dellinger RP, Levy MM, Carlet JM et al (2008) Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med 36(1):296–327

    Article  PubMed  Google Scholar 

  20. Penack O, Buchheidt D, Christopeit M et al (2011) Management of sepsis in neutropenic patients: guidelines from the infectious diseases working party of the German Society of Hematology and Oncology. Ann Oncol 22(5):1019–1029

    Article  PubMed  CAS  Google Scholar 

  21. Weeks JC, Catalano PJ, Cronin A et al (2012) Patients‘ expectations about effects of chemotherapy for advanced cancer. N Engl J Med 367(17):1616–1625

    Article  PubMed  CAS  Google Scholar 

  22. Smith TJ, Khatcheressian J, Lyman GH et al (2006) 2006 update of recommendations for the use of white blood cell growth factors: an evidence-based clinical practice guideline. J Clin Oncol 24(19):3187–3205

    Article  PubMed  CAS  Google Scholar 

  23. Moosmann A, Hammerschmidt W, Kolb H-J (2012) Virus-specific T cells for therapy – approaches, problems, solutions. Eur J Cell Biol 91(1):97–101

    Article  PubMed  CAS  Google Scholar 

  24. Hübel K, Engert A (2003) Granulocyte transfusion therapy for treatment of infections after cytotoxic chemotherapy. Onkologie 26(1):73–79

    Article  PubMed  Google Scholar 

  25. Gow KW, Lao OB, Leong T, Fortenberry JD (2010) Extracorporeal life support for adults with malignancy and respiratory or cardiac failure: the extracorporeal life support experience. Am J Surg 199(5):669–675

    Article  PubMed  Google Scholar 

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Correspondence to M. Kochanek or A. Shimabukuro-Vornhagen.

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Kochanek, M., von Bergwelt-Baildon, M. & Shimabukuro-Vornhagen, A. Infektionen bei hämatoonkologischen Patienten auf der Intensivstation. Med Klin Intensivmed Notfmed 108, 197–202 (2013). https://doi.org/10.1007/s00063-012-0179-x

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  • DOI: https://doi.org/10.1007/s00063-012-0179-x

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