Skip to main content
SpringerLink
Log in
Book cover

Principles and Practice of Cancer Infectious Diseases pp 87–91Cite as

Management of Infections in Critically Ill Cancer Patients

  • Chapter
  • First Online:

  • 1449 Accesses

Part of the book series: Current Clinical Oncology ((CCO))

Abstract

Advances in critical care medicine have enabled cancer patients to survive aggressive medical and surgical therapies that they could not have tolerated a decade ago. For patients whose goals can be met by ICU support, the diagnostic and empiric therapeutic approach will be far different than when patients are more stable in other hospital areas: evaluations must be completed rapidly while patients are able to tolerate such testing, and empiric therapy must be broad and promptly administered. Oncologists and infectious disease specialists need to be actively involved in evaluating cancer patients in the ICU and in developing their management plans due to the enhanced knowledge they are likely to have of the patient’s history prior to the ICU, their knowledge of the underlying disease and life-threatening process, and their expertise in drug selection and monitoring.

An erratum to this chapter is available at http://dx.doi.org/10.1007/978-1-60761-644-3_51

An erratum to this chapter can be found at http://dx.doi.org/10.1007/978-1-60761-644-3_51

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   259.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Darmon M, Azoulay E. Critical care management of cancer patients: cause for optimism and need for objectivity. Curr Opin Oncol. 2009;21:318–26.

    Article  PubMed  Google Scholar 

  2. Azoulay E, Afessa B. The intensive care support of patients with malignancy: do everything that can be done. Intensive Care Med. 2006;32:3–5.

    Article  PubMed  Google Scholar 

  3. Soares M, Azoulay E. Critical care management of lung cancer patients to prolong life without prolonging dying. Intensive Care Med 2009.

    Google Scholar 

  4. Soares M. Salluh JI, Azoulay E. Noninvasive ventilation in patients with malignancies and hypoxemic acute respiratory failure: A still pending question. J Crit Care; 2009.

    Google Scholar 

  5. Pene F, Percheron S, Lemiale V, et al. Temporal changes in management and outcome of septic shock in patients with malignancies in the intensive care unit. Crit Care Med. 2008;36:690–6.

    Article  PubMed  Google Scholar 

  6. Larche J, Azoulay E, Fieux F, et al. Improved survival of critically ill cancer patients with septic shock. Intensive Care Med. 2003;29:1688–95.

    Article  PubMed  Google Scholar 

  7. Benoit DD, Vandewoude KH, Decruyenaere JM, Hoste EA, Colardyn FA. Outcome and early prognostic indicators in patients with a hematologic malignancy admitted to the intensive care unit for a life-threatening complication. Crit Care Med. 2003;31:104–12.

    Article  PubMed  Google Scholar 

  8. Lamia B, Hellot MF, Girault C, et al. Changes in severity and organ failure scores as prognostic factors in onco-hematological malignancy patients admitted to the ICU. Intensive Care Med. 2006;32:1560–8.

    Article  CAS  PubMed  Google Scholar 

  9. Park HY, Suh GY, Jeon K, et al. Outcome and prognostic factors of patients with acute leukemia admitted to the intensive care unit for septic shock. Leuk Lymphoma. 2008;49:1929–34.

    Article  PubMed  Google Scholar 

  10. Thakkar SG, Fu AZ, Sweetenham JW, et al. Survival and predictors of outcome in patients with acute leukemia admitted to the intensive care unit. Cancer. 2008;112:2233–40.

    Article  PubMed  Google Scholar 

  11. Investigators TSP. A controlled trial to improve care for seriously ill hospitalized patients. The study to understand prognoses and preferences for outcomes and risks of treatments (SUPPORT). The SUPPORT Principal Investigators. Jama 1995;274:1591-8.

    Google Scholar 

  12. Angus DC, Barnato AE, Linde-Zwirble WT, et al. Use of intensive care at the end of life in the United States: an epidemiologic study. Crit Care Med. 2004;32:638–43.

    Article  PubMed  Google Scholar 

  13. Curtis JR, Rubenfeld GD. Introducing the concept of managing death in the ICU. In: Curtis JR, Rubenfeld GD, eds. Managing death in the intensive care unit. New York: Oxford University Press; 2001:3.

    Google Scholar 

  14. Thiery G, Azoulay E, Darmon M, et al. Outcome of cancer patients considered for intensive care unit admission: a hospital-wide prospective study. J Clin Oncol. 2005;23:4406–13.

    Article  PubMed  Google Scholar 

  15. Brenner H. Long-term survival rates of cancer patients achieved by the end of the 20th century: a period analysis. Lancet. 2002;360:1131–5.

    Article  PubMed  Google Scholar 

  16. Ferra C, Marcos P, Misis M, et al. Outcome and prognostic factors in patients with hematologic malignancies admitted to the intensive care unit: a single-center experience. Int J Hematol. 2007;85:195–202.

    Article  PubMed  Google Scholar 

  17. Massion PB, Dive AM, Doyen C, et al. Prognosis of hematologic malignancies does not predict intensive care unit mortality. Crit Care Med. 2002;30:2260–70.

    Article  PubMed  Google Scholar 

  18. Lecuyer L, Chevret S, Thiery G, Darmon M, Schlemmer B, Azoulay E. The ICU trial: a new admission policy for cancer patients requiring mechanical ventilation. Crit Care Med. 2007;35:808–14.

    Article  PubMed  Google Scholar 

  19. Soubani AO, Kseibi E, Bander JJ, et al. Outcome and prognostic factors of hematopoietic stem cell transplantation recipients admitted to a medical ICU. Chest. 2004;126:1604–11.

    Article  PubMed  Google Scholar 

  20. Rabbat A, Chaoui D, Montani D, et al. Prognosis of patients with acute myeloid leukaemia admitted to intensive care. Br J Haematol. 2005;129:350–7.

    Article  PubMed  Google Scholar 

  21. Merz TM, Schar P, Buhlmann M, Takala J, Rothen HU. Resource use and outcome in critically ill patients with hematological malignancy: a retrospective cohort study. Crit Care. 2008;12:R75.

    Article  PubMed  Google Scholar 

  22. Benoit DD, Hoste EA, Depuydt PO, et al. Outcome in critically ill medical patients treated with renal replacement therapy for acute renal failure: comparison between patients with and those without haematological malignancies. Nephrol Dial Transplant. 2005;20:552–8.

    Article  PubMed  Google Scholar 

  23. den Boer S, de Keizer NF, de Jonge E. Performance of prognostic models in critically ill cancer patients - a review. Crit Care. 2005;9:R458–63.

    Article  Google Scholar 

  24. Beck DH, Smith GB, Pappachan JV, Millar B. External validation of the SAPS II, APACHE II and APACHE III prognostic models in South England: a multicentre study. Intensive Care Med. 2003;29:249–56.

    PubMed  Google Scholar 

  25. Gondos A, Bray F, Hakulinen T, Brenner H. Trends in cancer survival in 11 European populations from 1990 to 2009: a model-based analysis. Ann Oncol. 2009;20:564–73.

    Article  CAS  PubMed  Google Scholar 

  26. Kumar A, Roberts D, Wood KE, et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med. 2006;34:1589–96.

    Article  PubMed  Google Scholar 

  27. Miner JR, Heegaard W, Mapes A, Biros M. Presentation, time to antibiotics, and mortality of patients with bacterial meningitis at an urban county medical center. J Emerg Med. 2001;21:387–92.

    Article  CAS  PubMed  Google Scholar 

  28. Proulx N, Frechette D, Toye B, Chan J, Kravcik S. Delays in the administration of antibiotics are associated with mortality from adult acute bacterial meningitis. Qjm. 2005;98:291–8.

    Article  CAS  PubMed  Google Scholar 

  29. Funk D, Sebat F, Kumar A. A systems approach to the early recognition and rapid administration of best practice therapy in sepsis and septic shock. Curr Opin Crit Care. 2009;15:301–7.

    Article  PubMed  Google Scholar 

  30. Marchaim D, Kaye KS, Fowler VG, et al. Case-control study to identify factors associated with mortality among patients with methicillin-resistant Staphylococcus aureus bacteraemia. Clin Microbiol Infect 2009.

    Google Scholar 

  31. Garey KW, Rege M, Pai MP, et al. Time to initiation of fluconazole therapy impacts mortality in patients with candidemia: a multi-institutional study. Clin Infect Dis. 2006;43:25–31.

    Article  CAS  PubMed  Google Scholar 

  32. Morrell M, Fraser VJ, Kollef MH. Delaying the empiric treatment of candida bloodstream infection until positive blood culture results are obtained: a potential risk factor for hospital mortality. Antimicrob Agents Chemother. 2005;49:3640–5.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

Disclaimer: The opinions and assertions contained herein are those of the authors and are not to be construed as official or as reflecting the views of the Department of Defense, the Department of the Navy, or the naval services at large.

Disclaimer: The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the U.S. Department of the Army or the U.S. Department of Defense.

Author information

Authors and Affiliations

  1. Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, 20892, USA

    Henry Masur

Authors
  1. Henry Masur
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Henry Masur .

Editor information

Editors and Affiliations

  1. MD Anderson Cancer Center, Infectious Diseases Department, The University of Texas, 800 5th Avenue, Apt. 12-G, New York, 10065, New York, USA

    Amar Safdar

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Masur, H. (2011). Management of Infections in Critically Ill Cancer Patients. In: Safdar, A. (eds) Principles and Practice of Cancer Infectious Diseases. Current Clinical Oncology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-644-3_7

Download citation

  • DOI: https://doi.org/10.1007/978-1-60761-644-3_7

  • Published:

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60761-643-6

  • Online ISBN: 978-1-60761-644-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation