Wagner A, Staudinger T, Kofler J, Keil F, Röggla G, Röggla M, Locker G J, Kalhs P, Müllner M, Binder M, Frass M
Abteilung für Notfallmedizin, Allgemeines Krankenhaus der Stadt Wien.
Wien Klin Wochenschr. 1996;108(21):677-82.
In a retrospective study we investigated the clinical course of patients who required intensive care support after bone marrow transplantation. Out of 25 patients only 5 (20%) survived treatment in the intensive care unit (ICU) and this group showed a significantly lower age, lower APACHE III and organ-failure scores and higher serum albumin values, as well as a longer interval between bone marrow transplantation and admission to intensive care. However, no patient requiring mechanical ventilation primarily for pneumonia or other infections arising as a complication of bone marrow transplantation survived intensive care. All patients requiring ventilation for more than 24 hours died in hospital. Of the 5 patients surviving ICU treatment only 3 were eventually discharged from hospital and only one single patient was alive after 6 months. Hence, current intensive care management appears to be indicated in only a small group of patients after bone marrow transplantation.
在一项回顾性研究中,我们调查了骨髓移植后需要重症监护支持的患者的临床病程。在25例患者中,只有5例(20%)在重症监护病房(ICU)接受治疗后存活,该组患者年龄显著更低,急性生理学及慢性健康状况评分系统III(APACHE III)和器官衰竭评分更低,血清白蛋白值更高,并且骨髓移植与入住重症监护病房之间的间隔时间更长。然而,主要因骨髓移植并发症引起的肺炎或其他感染而需要机械通气的患者,无一例在重症监护中存活。所有需要通气超过24小时的患者均在医院死亡。在ICU治疗后存活的5例患者中,最终只有3例出院,6个月后只有1例还活着。因此,目前的重症监护管理似乎仅适用于一小部分骨髓移植后的患者。