Critical care of the pediatric oncology patient.

The survival rate of children with neoplastic disease has increased significantly because of advances in the diagnosis and treatment of malignancy. The consequences of these scientific advances have led to increased malignancy-related critical complications requiring the expertise of intensive care practitioners. In this article, the authors review common complication associated with malignancies that require admission to the pediatric intensive care unit. Disorders are grouped according to the pathophysiologic mechanism: mechanical effects, systemic effects, related to brain tumors, and complications of intensive chemotherapy or chemo-radiotherapy regimens. Superior vena cava syndrome and brain tumors are described in detail. In conclusion, there is a discussion of outcome data for children with neoplastic disease who are admitted to the pediatric intensive care unit and the role of the advanced practice nurse in influencing patient and family perceptions of the experience.