Outcome Of Pediatric Oncologic Patients in the Respiratory Intensive Care Unit : Siriraj Hospital
CHAKRAPHAN SUS IV A, M.D.*, SRIASSANCEE KEERA TIRUANGRONG, M.D.*
Affiliation : *Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700,Thailand.
Objectives : To review the characteristics and outcome of patients with childhood malig nancy requiring respiratory intensive care treatment and to assess the outcome of these patients.
Design : Retrospective review of 22 oncological patients admitted to the pediatric respi ratory intensive care unit between January 1, 1996 and December 31, 1998 (total 3 years.)
Results : The overall survival at discharge from the intensive care unit was 10 out of 22 (45%). The mean age of the patients was 4 years 5 months old (range 1 month to 14 years ). Male : Female ratio was 1.2 : 1. 21 patients had fever. All patients with a systemic or respiratory infective illness were neutropenic with a positive hemoculture in 17 out of 21 (81%) and 10 out of 20 (50%), respectively. The most common organisms detected were coagulase negative Staphylo coccal aureus and Escherichia Coli. Sputum culture in the respiratory failure group was positive in 3 out of 7 patients, all of them grew Pseudomonas aeruginosa. Antibiotics were given to all oncological patients presenting with fever. The most common antibiotics administered were Cefta zidime, Amikacin and Imipenem. Fourteen patients needed mechanical ventilation. 11 of these 14 patients had respiratory tract infections, 1 patient had acute respiratory distress syndrome and the remainder were in a coma as a result of brain metastasis. Only 2 of them survived. The mean dura tion of stay in the respiratory intensive care unit was 10.9 days.
Conclusions : There has been an improvement in the survival of oncology patients admitted to the intensive care unit especially for those with either a systemic or respiratory infection. Early and full intensive care treatment should be provided for these patients in order to improve the out come.
Keywords : Intensive Care, Oncology, Infection, Survival
