Critical care clinics
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A variety of renal diseases and electrolyte disorders may be associated with various malignancies or with treatment of malignancy with chemotherapeutic drugs or radiation. This article reviews renal disease in cancer patients, which constitutes a major source of morbidity and mortality.
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Critical care clinics · Jul 2001
ReviewAcute respiratory failure in critically ill patients with cancer. Diagnosis and management.
Respiratory failure remains a common cause of admission to the ICU for patients with cancer, regardless of the nature of malignancy. The diagnosis and management of ARF in patients with cancer poses special challenges to the intensivist. ⋯ Severity-of-illness scoring systems and mortality probability models, although useful in discriminating between survivors and nonsurvivors in large groups of critically ill patients, should not be used alone to justify reluctance in admitting individual patients with cancer with potentially reversible respiratory failure to the ICU. Close collaboration between oncologists and intensivists will ensure the establishment of clear goals and direction of treatment for every patient with cancer who requires mechanical ventilation.
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Patients with cancer are at risk for developing a variety of fluid and electrolyte disturbances caused by the disease process or by complications from therapy. An understanding of the pathophysiology of these potential abnormalities allows the clinician to manage patients expectantly and to avoid severe metabolic disarray by correcting imbalances promptly.
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Caring for a critically ill patient with cancer requires another dimension of care when compared with caring for patients in a general ICU. The oncology critical care staff deals with an acute event and with the multidimensional aspects of care of a patient with a cancer diagnosis. ⋯ Effective management requires a multidisciplinary approach to care. Skilled and knowledgeable care and communication among all members of the team are essential to prevent, minimize, and treat these symptoms and to achieve optimal patient outcomes.