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Pediatrics
Outcomes of extracorporeal membrane oxygenation support in pediatric hemato-oncology patients
Hong Yul An, Hyoung Jin Kang, June Dong Park
Acute Crit Care. 2024;39(1):108-116.   Published online January 24, 2024
DOI: https://doi.org/10.4266/acc.2023.01088
  • 726 View
  • 72 Download
AbstractAbstract PDFSupplementary Material
Background
In this study, we reviewed the outcomes of pediatric patients with malignancies who underwent hematopoietic stem cell transplantation (HSCT) and extracorporeal membrane oxygenation (ECMO). Methods: We retrospectively analyzed the records of pediatric hemato-oncology patients treated with chemotherapy or HSCT and who received ECMO in the pediatric intensive care unit (PICU) at Seoul National University Children’s Hospital from January 2012 to December 2020. Results: Over a 9-year period, 21 patients (14 males and 7 females) received ECMO at a single pediatric institute; 10 patients (48%) received veno-arterial (VA) ECMO for septic shock (n=5), acute respiratory distress syndrome (ARDS) (n=3), stress-induced myopathy (n=1), or hepatopulmonary syndrome (n=1); and 11 patients (52%) received veno-venous (VV) ECMO for ARDS due to pneumocystis pneumonia (n=1), air leak (n=3), influenza (n=1), pulmonary hemorrhage (n=1), or unknown etiology (n=5). All patients received chemotherapy; 9 received anthracycline drugs and 14 (67%) underwent HSCT. Thirteen patients (62%) were diagnosed with malignancies and 8 (38%) were diagnosed with non-malignant disease. Among the 21 patients, 6 (29%) survived ECMO in the PICU and 5 (24%) survived to hospital discharge. Among patients treated for septic shock, 3 of 5 patients (60%) who underwent ECMO and 5 of 10 patients (50%) who underwent VA ECMO survived. However, all the patients who underwent VA ECMO or VV ECMO for ARDS died. Conclusions: ECMO is a feasible treatment option for respiratory or heart failure in pediatric patients receiving chemotherapy or undergoing HSCT.
Hematology
Characteristics and Clinical Outcomes of Critically Ill Cancer Patients Admitted to Korean Intensive Care Units
Soo Jin Na, Tae Sun Ha, Younsuck Koh, Gee Young Suh, Shin Ok Koh, Chae-Man Lim, Won-Il Choi, Young-Joo Lee, Seok Chan Kim, Gyu Rak Chon, Je Hyeong Kim, Jae Yeol Kim, Jaemin Lim, Sunghoon Park, Ho Cheol Kim, Jin Hwa Lee, Ji Hyun Lee, Jisook Park, Juhee Cho, Kyeongman Jeon
Acute Crit Care. 2018;33(3):121-129.   Published online August 31, 2018
DOI: https://doi.org/10.4266/acc.2018.00143
  • 8,082 View
  • 272 Download
  • 7 Web of Science
  • 8 Crossref
AbstractAbstract PDF
Background
The objective of this study was to investigate the characteristics and clinical outcomes of critically ill cancer patients admitted to intensive care units (ICUs) in Korea.
Methods
This was a retrospective cohort study that analyzed prospective collected data from the Validation of Simplified Acute Physiology Score 3 (SAPS3) in Korean ICU (VSKI) study, which is a nationwide, multicenter, and prospective study that considered 5,063 patients from 22 ICUs in Korea over a period of 7 months. Among them, patients older than 18 years of age who were diagnosed with solid or hematologic malignancies prior to admission to the ICU were included in the present study.
Results
During the study period, a total of 1,762 cancer patients were admitted to the ICUs and 833 of them were deemed eligible for analysis. Six hundred fifty-eight (79%) had solid tumors and 175 (21%) had hematologic malignancies, respectively. Respiratory problems (30.1%) was the most common reason leading to ICU admission. Patients with hematologic malignancies had higher Sequential Organ Failure Assessment (12 vs. 8, P<0.001) and SAPS3 (71 vs. 69, P<0.001) values and were more likely to be associated with chemotherapy, steroid therapy, and immunocompromised status versus patients with solid tumors. The use of inotropes/ vasopressors, mechanical ventilation, and/or continuous renal replacement therapy was more frequently required in hematologic malignancy patients. Mortality rates in the ICU (41.7% vs. 24.6%, P<0.001) and hospital (53.1% vs. 38.6%, P=0.002) were higher in hematologic malignancy patients than in solid tumor patients.
Conclusions
Cancer patients accounted for one-third of all patients admitted to the studied ICUs in Korea. Clinical characteristics were different according to the type of malignancy. Patients with hematologic malignancies had a worse prognosis than did patients with solid tumor.

Citations

Citations to this article as recorded by  
  • Outcomes of Acute Respiratory Failure in Patients With Cancer in the United States
    Kiyan Heybati, Jiawen Deng, Archis Bhandarkar, Fangwen Zhou, Cameron Zamanian, Namrata Arya, Mohamad Bydon, Philippe R. Bauer, Ognjen Gajic, Allan J. Walkey, Hemang Yadav
    Mayo Clinic Proceedings.2024; 99(4): 578.     CrossRef
  • Characteristics and outcomes of cancer patients admitted to intensive care units in cancer specialized hospitals in China
    Wensheng Liu, Dongmin Zhou, Li Zhang, Mingguang Huang, Rongxi Quan, Rui Xia, Yong Ye, Guoxing Zhang, Zhuping Shen
    Journal of Cancer Research and Clinical Oncology.2024;[Epub]     CrossRef
  • Predictors of ICU mortality in patients with hemoblastosis and infectious complications
    A.V. Lyanguzov, A.S. Luchinin, S.V. Ignatyev, I.V. Paramonov
    Anesteziologiya i reanimatologiya.2023; (1): 33.     CrossRef
  • Effect of the underlying malignancy on critically ill septic patient's outcome
    Man‐Yee Man, Hoi‐Ping Shum, Sin‐Man Lam, Jacky Li, Wing‐Wa Yan, Mei‐Wan Yeung
    Asia-Pacific Journal of Clinical Oncology.2022; 18(4): 473.     CrossRef
  • Impacts of Corticosteroid Therapy at Acute Stage of Hospital-Onset Clostridioides difficile Infections
    Ching-Chi Lee, Jen-Chieh Lee, Chun-Wei Chiu, Pei-Jane Tsai, Wen-Chien Ko, Yuan-Pin Hung
    Infection and Drug Resistance.2022; Volume 15: 5387.     CrossRef
  • Hospital mortality and prognostic factors in critically ill patients with acute kidney injury and cancer undergoing continuous renal replacement therapy
    Da Woon Kim, Geum Suk Jang, Kyoung Suk Jung, Hyuk Jae Jung, Hyo Jin Kim, Harin Rhee, Eun Young Seong, Sang Heon Song
    Kidney Research and Clinical Practice.2022; 41(6): 717.     CrossRef
  • A Systematic Review and Meta-Analysis Evaluating Geographical Variation in Outcomes of Cancer Patients Treated in ICUs
    Lama H. Nazer, Maria A. Lopez-Olivo, Anne Rain Brown, John A. Cuenca, Michael Sirimaturos, Khader Habash, Nada AlQadheeb, Heather May, Victoria Milano, Amy Taylor, Joseph L. Nates
    Critical Care Explorations.2022; 4(9): e0757.     CrossRef
  • Clinico-demographic and Outcome Predictors in Solid Tumor Patients with Unplanned Intensive Care Unit Admissions: An Observational Study
    Jigeeshu Divatia, Amit M Narkhede, Harish K Chaudhari, Ujwal Dhundi, Natesh Prabu Ravisankar, Satish Sarode
    Indian Journal of Critical Care Medicine.2021; 25(12): 1421.     CrossRef
Hematology/Cardiology
Extracorporeal Membrane Oxygenation Support in Adult Patients with Hematologic Malignancies and Severe Acute Respiratory Failure
Tai Sun Park, You Na Oh, Sang-Bum Hong, Chae-Man Lim, Younsuck Koh, Je-Hwan Lee, Jung-Hee Lee, Kyoo-Hyung Lee, Jin Won Huh
Korean J Crit Care Med. 2016;31(3):243-250.   Published online August 30, 2016
DOI: https://doi.org/10.4266/kjccm.2016.00318
  • 8,827 View
  • 142 Download
  • 3 Crossref
AbstractAbstract PDF
Background
Administering extracorporeal membrane oxygenation (ECMO) to critically ill patients with acute respiratory distress syndrome has substantially increased over the last decade, however administering ECMO to patients with hematologic malignancies may carry a particularly high risk. Here, we report the clinical outcomes of patients with hematologic malignancies and severe acute respiratory failure who were treated with ECMO.
Methods
We performed a retrospective review of the medical records of patients with hematologic malignancies and severe acute respiratory failure who were treated with ECMO at the medical intensive care unit of a tertiary referral hospital between March 2010 and April 2015.
Results
A total of 15 patients (9 men; median age 45 years) with hematologic malignancies and severe acute respiratory failure received ECMO therapy during the study period. The median values of the Acute Physiology and Chronic Health Evaluation II score, Murray Lung Injury Score, and Respiratory Extracorporeal Membrane Oxygenation Survival Prediction Score were 29, 3.3, and -2, respectively. Seven patients received venovenous ECMO, whereas 8 patients received venoarterial ECMO. The median ECMO duration was 2 days. Successful weaning of ECMO was achieved in 3 patients. Hemorrhage complications developed in 4 patients (1 pulmonary hemorrhage, 1 intracranial hemorrhage, and 2 cases of gastrointestinal bleeding). The longest period of patient survival was 59 days after ECMO initiation. No significant differences in survival were noted between venovenous and venoarterial ECMO groups (10.0 vs. 10.5 days; p = 0.56).
Conclusions
Patients with hematologic malignancies and severe acute respiratory failure demonstrate poor outcomes after ECMO treatment. Careful and appropriate selection of candidates for ECMO in these patients is necessary.

Citations

Citations to this article as recorded by  
  • Extracorporeal membrane oxygenation in patients with hematologic malignancies: a systematic review and meta-analysis
    Jackie Jia Lin Sim, Saikat Mitra, Ryan Ruiyang Ling, Chuen Seng Tan, Bingwen Eugene Fan, Graeme MacLaren, Kollengode Ramanathan
    Annals of Hematology.2022; 101(7): 1395.     CrossRef
  • Extracorporeal Membrane Oxygenation with rituximab‐combined chemotherapy in AIDS‐associated primary cardiac lymphoma: A case report
    Hoyuri Fuseya, Takuro Yoshimura, Minako Tsutsumi, Yosuke Nakaya, Mirei Horiuchi, Masahiro Yoshida, Yoshiki Hayashi, Takafumi Nakao, Takeshi Inoue, Takahisa Yamane
    Clinical Case Reports.2021;[Epub]     CrossRef
  • Extracorporeal Life Support in Adult Patients with Hematologic Malignancies and Acute Circulatory and/or Respiratory Failure
    Sungbin Cho, Won Chul Cho, Ju Yong Lim, Pil Je Kang
    The Korean Journal of Thoracic and Cardiovascular Surgery.2019; 52(1): 25.     CrossRef
Case Reports
Thoracic Surgery
Acute Peripheral Arterial Tumorous Embolism after Lung Cancer Surgery
Yoohwa Hwang, Hyun Joo Lee, Young Tae Kim
Korean J Crit Care Med. 2015;30(3):234-237.   Published online August 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.3.234
  • 4,518 View
  • 63 Download
AbstractAbstract PDF
Systemic tumor embolisms after pulmonary resections for malignancy are rare, but usually severe and sometimes fatal. Here, we report a case of a 70-year-old woman who underwent pulmonary resection for lung cancer and subsequently developed acute arterial occlusion of the lower extremities caused by a tumorous embolus.
Pulmonary/Thoracic Surgery
Successful Management of Airway Emergency in a Patient with Esophageal Cancer
Samina Park, Hyun Joo Lee, Chang Hyun Kang, Young Tae Kim
Korean J Crit Care Med. 2015;30(2):135-138.   Published online May 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.2.135
  • 8,000 View
  • 98 Download
  • 2 Crossref
AbstractAbstract PDF
A 60-year-old man with advanced esophageal cancer was admitted for surgical placement of a feeding jejunostomy tube before commencement of chemoradiotherapy. His esophageal cancer had directly invaded the posterior tracheal wall, inducing a nearly total obstruction of the distal trachea. On the day before the surgery, respiratory failure developed due to tumor progression and tracheal edema. Tracheal intubation and mechanical ventilation were attempted without success. Application of veno-venous extracorporeal membrane oxygenation (ECMO) corrected the patient’s respiratory acidosis and relieved his dyspnea. With full ECMO support, he underwent tracheal stent insertion. Two hours later, he was weaned from ECMO support uneventfully. This was a successful case of tracheal stenting for airway obstruction under rescue veno-venous ECMO.

Citations

Citations to this article as recorded by  
  • An esophageal tumor producing life-threatening tracheal compression in a young adult was resuscitated with a self-inflating resuscitation bag
    Rajnish Kumar, Nishant Sahay, Neeraj Kumar, Soumya Singh
    Perioperative Care and Operating Room Management.2024; 34: 100365.     CrossRef
  • Thoracic oesophageal cancer as a cause of stridor: a literature review
    Robert Munashe Maweni, Venughanan Manikavasagar, Nicholas Sunderland, Sajid Chaudhry
    BMJ Case Reports.2018; : bcr-2018-224872.     CrossRef

ACC : Acute and Critical Care