Ñamendys-Silva Silvio A, Ruiz-Beltran Arturo M, Barragán-Dessavre Mireya, Bautista-Ocampo Andoreni R, Meneses-García Abelardo, González-Chon Octavio, Herrera-Gómez Angel
Department of Critical Care Medicine, Instituto Nacional de Cancerología, Mexico City 14080, Mexico.
Department of Critical Care Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico.
Mol Clin Oncol. 2017 Nov;7(5):747-750. doi: 10.3892/mco.2017.1401. Epub 2017 Aug 31.
The aim of the present study was to investigate the incidence of organ dysfunction, and to describe the clinical characteristics and intensive care unit (ICU) outcomes of critically ill cancer patients who were admitted to an oncological ICU during the isolated limb perfusion post-operative period. The present study was an observational investigation of 42 critically ill cancer patients who were admitted to the ICU of the Instituto Nacional de Cancerología, during the isolated limb perfusion post-operative period, between July 2010 and February 2016. The mean age of the patients was 45.7±16.9 years, and 45.2% (19 cases) were female. Soft tissue sarcoma was the most common pre-operative diagnosis (38.1%), and the mean duration of surgery was 267.6±50.1 min. Furthermore, a mean blood loss volume of 732.3±526.1 ml during the procedure was recorded, and the patients received a mean volume of 3.88±1.28 l crystalloid fluid during the surgical procedure, subsequently requiring an additional 2.95±6.28 l on the first post-operative day. The incidence of organ dysfunction was 90.5% and was most frequently noted in the respiratory (81%), hepatic (33%), hematologic (31%) and renal (11.9%) systems. No patients succumbed to the disease during the ICU and hospital stay. Nevertheless, <10% of the patients required vasopressors. Additionally, <5% of the patients required invasive mechanical ventilation. Therefore, ICU admission directly following isolated limb perfusion should not be standardized.
本研究的目的是调查器官功能障碍的发生率,并描述在肢体隔离灌注术后入住肿瘤重症监护病房(ICU)的重症癌症患者的临床特征及ICU治疗结局。本研究是一项针对42例重症癌症患者的观察性调查,这些患者于2010年7月至2016年2月期间在肢体隔离灌注术后入住国立癌症研究所的ICU。患者的平均年龄为45.7±16.9岁,45.2%(19例)为女性。软组织肉瘤是最常见的术前诊断(38.1%),平均手术时长为267.6±50.1分钟。此外,术中记录的平均失血量为732.3±526.1毫升,患者在手术过程中平均接受了3.88±1.28升晶体液,术后第一天还需要额外补充2.95±6.28升。器官功能障碍的发生率为90.5%,最常见于呼吸系统(81%)、肝脏系统(33%)、血液系统(31%)和肾脏系统(11.9%)。在ICU和住院期间,没有患者因病死亡。然而,<10%的患者需要使用血管升压药。此外,<5%的患者需要有创机械通气。因此,肢体隔离灌注术后直接入住ICU不应标准化。