• Klinische Pädiatrie · May 2011

    Management of oncology patients admitted to the paediatric intensive care unit of a general children's hospital - a single center analysis.

    • R Haase, U Lieser, C Kramm, M Stiefel, C Vilser, T Bernig, N Merkel, C Mauz-Körholz, and D Körholz.
    • Department of Pediatrics, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany. roland.haase@medizin.uni-halle.de
    • Klin Padiatr. 2011 May 1;223(3):142-6.

    BackgroundThe improving prognosis of children with cancer has partially been attributed to the increasing importance of pediatric intensive care units (PICU). We analyze whether outcome of these patients on a PICU improved during the last decade and which factors may influence the outcome in our hospital.Patients And MethodsThe charts of all oncology patients admitted to the PICU between 1998 and 2009 have been reviewed retrospectively. The survival of patients admitted for life threatening complications has been correlated with basic data, organ failure and the PRISM score. The results of 2 consecutive treatment periods (1998-2003 and 2004-2009) were compared.Results644 admissions of 226 patients were recorded. 79 admissions were performed because of potentially life threatening complications (Group A), 236 for monitoring (B) and 329 admissions for interventions (C). 62% of Group A patients and all Group B and C patients were discharged alive. Poor outcome was associated with admission >28 days after initial diagnosis, PRISM >10, organ failure >2 organs, sepsis, allogeneic stem cell transplantation, need for mechanical ventilation or for catecholamines. The PICU survival rate of Group A patients admitted between 2004 and 2009 (78%) was higher than in the period between 1998 and 2003 (48%).ConclusionsPICU provides essential services to support the pediatric oncology ward. Although children with cancer may have had benefit from advances in pediatric intensive care over the past decade, specific scoring systems for early identification of children with cancer needing PICU treatment are required. These systems might further improve PICU outcome in critical ill pediatric cancer patients.© Georg Thieme Verlag KG Stuttgart · New York.

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