Munshi Laveena, Dumas Guillaume, Ferreryro Bruno, Gutierrez Cristina, Böll Boris, Castro Pedro, Chawla Sanjay, Di Nardo Matteo, Lafarge Antoine, McEvoy Colleen, Mokart Djamel, Nassar Antonio Paulo, Nelson Judith, Pène Frédéric, Schellongowski Peter, Azoulay Elie
Department of Medicine, Interdepartmental Division of Critical Care Medicine, Sinai Health System, University of Toronto, Toronto, Canada.
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
Intensive Care Med. 2025 Apr;51(4):742-755. doi: 10.1007/s00134-025-07865-6. Epub 2025 Apr 16.
Significant advancements have been made in the care of the allogeneic hematopoietic stem cell (HCT) recipient. However, they remain one of the most vulnerable groups of patients who may be admitted to the ICU. On the one hand, they have been administered treatment with the goal of achieving cure for their underlying disease, yet their unique immunocompromised trajectory and treatment-associated toxicities continue to challenge the intensivist from a diagnostic and management perspective. While infectious disease, allogeneic HCT and critical care research have improved outcomes, there remain significant areas to advance critical care management to further increase the likelihood of bridging to an acceptable quality of life. This review focuses on care of the critically ill patient undergoing allogeneic HCT for hematologic malignancies, critical care conditions that may arise, contemporary practices in their management, and areas to focus future research.
异基因造血干细胞（HCT）接受者的护理取得了重大进展。然而，他们仍然是可能入住重症监护病房（ICU）的最脆弱患者群体之一。一方面，他们接受治疗的目的是治愈潜在疾病，但其独特的免疫受损过程和与治疗相关的毒性，从诊断和管理角度来看，仍继续给重症监护医生带来挑战。虽然传染病、异基因HCT和重症监护研究已经改善了治疗结果，但在推进重症监护管理以进一步提高过渡到可接受生活质量的可能性方面，仍有重大领域有待改进。本综述重点关注接受异基因HCT治疗血液系统恶性肿瘤的重症患者的护理、可能出现的重症监护情况、其管理的当代实践以及未来研究的重点领域。
