Service de Médecine Interne, Soins Intensifs et Urgences Oncologiques, Institut Jules Bordet (Université Libre de Bruxelles, ULB), Rue Héger-Bordet, 1, 1000, Brussels, Belgium.
Service d'hématologie, Institut Jules Bordet (Université Libre de Bruxelles, ULB), Bruxelles, Belgique.
Intensive Care Med. 2021 Oct;47(10):1063-1077. doi: 10.1007/s00134-021-06508-w. Epub 2021 Sep 20.
To respond to the legitimate questions raised by the application of invasive methods of monitoring and life-support techniques in cancer patients admitted in the ICU, the European Lung Cancer Working Party and the Groupe de Recherche Respiratoire en Réanimation Onco-Hématologique, set up a consensus conference. The methodology involved a systematic literature review, experts' opinion and a final consensus conference about nine predefined questions1. Which triage criteria, in terms of complications and considering the underlying neoplastic disease and possible therapeutic limitations, should be used to guide admission of cancer patient to intensive care units?2. Which ventilatory support [High Flow Oxygenation, Non-invasive Ventilation (NIV), Invasive Mechanical Ventilation (IMV), Extra-Corporeal Membrane Oxygenation (ECMO)] should be used, for which complications and in which environment?3. Which support should be used for extra-renal purification, in which conditions and environment?4. Which haemodynamic support should be used, for which complications, and in which environment?5. Which benefit of cardiopulmonary resuscitation in cancer patients and for which complications?6. Which intensive monitoring in the context of oncologic treatment (surgery, anti-cancer treatment …)?7. What specific considerations should be taken into account in the intensive care unit?8. Based on which criteria, in terms of benefit and complications and taking into account the neoplastic disease, patients hospitalized in an intensive care unit (or equivalent) should receive cellular elements derived from the blood (red blood cells, white blood cells and platelets)?9. Which training is required for critical care doctors in charge of cancer patients?
为了回应在 ICU 收治的癌症患者中应用有创监测方法和生命支持技术所引发的合理问题,欧洲肺癌工作组和重症医学肿瘤呼吸研究小组组织了一次共识会议。该方法涉及系统的文献回顾、专家意见以及关于 9 个预先定义问题的最终共识会议 1. 基于并发症,并考虑到潜在的肿瘤疾病和可能的治疗限制,应采用哪些分诊标准来指导癌症患者入住重症监护病房?2. 应使用哪种通气支持[高流量氧疗、无创通气(NIV)、有创机械通气(IMV)、体外膜氧合(ECMO)],用于哪些并发症,在何种环境下?3. 应在何种条件和环境下使用肾脏外净化?4. 应使用哪种血液动力学支持,用于哪些并发症,以及在何种环境下?5. 癌症患者心肺复苏的益处是什么,以及哪些并发症?6. 在肿瘤治疗(手术、抗癌治疗等)的背景下应进行何种强化监测?7. 在重症监护病房中应考虑哪些具体问题?8. 根据获益和并发症的标准,并考虑到肿瘤疾病,在重症监护病房(或同等条件)住院的患者应接受来自血液的细胞成分(红细胞、白细胞和血小板),基于哪些标准?9. 负责癌症患者的重症监护医生需要接受哪些培训?