Ninotchka Brydges is Manager and Advanced Practice Provider, Department of Critical Care Medicine, Division of Anesthesia, Critical Care and Pain Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston TX 77030 (
Garry J. Brydges is Director, Anesthesia Safety and Quality, Department of Anesthesiology, Division of Anesthesia, Critical Care and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
AACN Adv Crit Care. 2021 Sep 15;32(3):306-314. doi: 10.4037/aacnacc2021832.
A new cancer diagnosis is expected to affect approximately 1.9 million people in the United States in 2021. A small percentage of these patients will experience an emergent cancer-related complication. Oncologic emergencies may be encountered in emergency departments or require intensive care management. Patients newly diagnosed with cancer are more likely to present with emergencies related to the underlying malignancies. Oncologic emergencies can have various manifestations, ranging from mechanical obstruction due to tumor growth to metabolic derangements due to abnormal secretions from the tumor. Therefore, early identification and treatment of life-threatening oncologic events is critical. Although there are several different types of oncologic emergencies, this article focuses on metabolic emergencies (tumor lysis syndrome and cytoreductive hyperthermic intraperitoneal chemotherapy) and structural emergencies (increased intracranial pressure and vena cava thrombus). The purpose of this article is to provide acute care clinicians with an overview of selected oncologic emergencies and their evidence-based management.
预计 2021 年美国将有大约 190 万人被诊断出患有癌症。其中一小部分患者会出现紧急的癌症相关并发症。肿瘤急症可能发生在急诊科，也可能需要重症监护管理。新诊断为癌症的患者更有可能出现与基础恶性肿瘤相关的急症。肿瘤急症的表现多种多样，从肿瘤生长引起的机械性梗阻到肿瘤异常分泌引起的代谢紊乱。因此，早期识别和治疗危及生命的肿瘤急症至关重要。虽然有几种不同类型的肿瘤急症，但本文重点介绍代谢急症（肿瘤溶解综合征和细胞减灭性高热腹腔化疗）和结构急症（颅内压增高和腔静脉血栓形成）。本文的目的是为急性护理临床医生提供所选肿瘤急症及其循证管理的概述。
