Medizinische Klinik, Intensivmedizin und Notfallmedizin
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Med Klin Intensivmed Notfmed · Apr 2013
Review[Cancer patients in the intensive care unit. Goals of therapy, ethics, and palliation].
Providing critical care to cancer patients requires a high degree of practical multidisciplinary teamwork between intensivists and cancer specialists. Intensivists should have a solid basic knowledge of malignant diseases as well as of the typical complications of the underlying illness and its therapies. ⋯ Both parties should have a realistic impression of the short-term intensive care and long-term oncologic options and perspectives of the respective patient. Good cooperation between intensivists and cancer specialists is the basis for meaningful decisions on admission, planning of individual therapeutic aims, successful patient management, and tailored therapy, with a smooth transition into a palliative care setting whenever appropriate.
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Med Klin Intensivmed Notfmed · Apr 2013
Review[Hematooncology patients in intensive care management].
Critically ill cancer patients on intensive units with hematological or oncological underlying diseases are a special situation: the underlying disease may be incurable, acute problems are often therapy associated and immunosuppression is regularly present. Due to evolving knowledge about special aspects of these patients and optimized supportive therapy, the prognosis has substantially improved during the last decades. General reluctance to admit cancer patients to an intensive care unit is therefore no longer justified. ⋯ Extensive diagnostic measures, causal and supportive therapy of sepsis according to current guidelines has led to improved outcome even in cancer patients. In respiratory failure, non-invasive ventilation is the key to improved prognosis if used early enough and indications, contraindications and break-off criteria are strictly followed. The prognosis of critically ill cancer patients is determined by the severity of the acute problem and not by the underlying disease.
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Med Klin Intensivmed Notfmed · Apr 2013
Case Reports[Hyponatremic encephalopathy with non-cardiogenic pulmonary edema. Development following marathon run].
This article presents the case of a 52-year-old woman who developed exercise-associated hyponatremia (EAH) complicated by non-cardiogenic pulmonary edema after a marathon run. The condition of EAH is a potentially life-threatening complication of endurance exercise. ⋯ Known risk factors are female gender, slow running pace and lack of weight loss. Emergency therapy is fluid restriction and bolus infusion of 3% NaCl solution to rapidly reduce brain edema.