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Critical Care in Paediatric Tumours

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Onco-critical Care

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Abstract

Oncological emergencies in children have comparatively favorable outcome with prompt recognition and institution of treatment. The common situations in children with cancer requiring critical care are either disease related emergencies or therapy related complications. Common oncological emergencies in children include hyperleukocytosis, tumor lysis syndrome, superior vena cava syndrome/superior mediastinal syndrome and malignant spinal cord compression. Hyperleukocytosis affects lungs and central nervous system due to increase in blood viscosity while tumor lysis syndrome causes metabolic derangements due to rapid turnover and cell lysis with subsequent renal failure or cardiac-arrythmias. Management of hyperleukocytosis and tumor lysis syndrome is directed towards aggressive hydration, monitoring and management of electrolyte disturbances, management of uric acid and blood product support. Superior vena cava syndrome in children is often due to a malignant mediastinal mass. It is managed with prompt initiation of steroids even on empiric basis. Use of sedatives is to be strictly avoided and diagnosis is to be established quickly and non-invasively. Recognition of malignant spinal cord compression in younger children is often delayed. Rapid initiation of steroid is essential in suspected cord compression to ensure neurological recovery. Neurosurgical intervention is necessary especially for intradural lesions whereas multi-modality therapy can be considered for extra-dural lesions.

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Authors and Affiliations

  1. Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, AIIMS, New Delhi, India

    Shuvadeep Ganguly & Deepam Pushpam

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  1. Shuvadeep Ganguly
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  2. Deepam Pushpam
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Editors and Affiliations

  1. Department of Onco-Anesthesia and Palliative Medicine, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India

    Vinod Kumar

  2. Department of Onco-Anesthesia and Palliative Medicine, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, Delhi, India

    Nishkarsh Gupta

  3. Department of Onco-Anesthesia and Palliative Medicine, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India

    Seema Mishra

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Ganguly, S., Pushpam, D. (2022). Critical Care in Paediatric Tumours. In: Kumar, V., Gupta, N., Mishra, S. (eds) Onco-critical Care. Springer, Singapore. https://doi.org/10.1007/978-981-16-9929-0_31

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  • DOI: https://doi.org/10.1007/978-981-16-9929-0_31

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-16-9928-3

  • Online ISBN: 978-981-16-9929-0

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