Outcome of pediatric oncologic patients in the respiratory intensive care unit: Siriraj Hospital.
OBJECTIVE
To review the characteristics and outcome of patients with childhood malignancy requiring respiratory intensive care treatment and to assess the outcome of these patients.


METHODS
Retrospective review of 22 oncological patients admitted to the pediatric respiratory intensive care unit between January 1, 1996 and December 31, 1998 (total 3 years.)


RESULTS
The overall survival at discharge from the intensive care unit was 10 out of 22 (45%). The mean age of the patients was 4 years 5 months old (range 1 month to 14 years). Male:Female ratio was 1.2:1.21 patients had fever. All patients with a systemic or respiratory infective illness were neutropenic with a positive hemoculture in 17 out of 21 (81%) and 10 out of 20 (50%), respectively. The most common organisms detected were coagulase negative Staphylococcal aureus and Escherichia Coli. Sputum culture in the respiratory failure group was positive in 3 out of 7 patients, all of them grew Pseudomonas aeruginosa. Antibiotics were given to all oncological patients presenting with fever. The most common antibiotics administered were Ceftazidime, Amikacin and Imipenem. Fourteen patients needed mechanical ventilation. 11 of these 14 patients had respiratory tract infections, 1 patient had acute respiratory distress syndrome and the remainder were in a coma as a result of brain metastasis. Only 2 of them survived. The mean duration of stay in the respiratory intensive care unit was 10.9 days.


CONCLUSIONS
There has been an improvement in the survival of oncology patients admitted to the intensive care unit especially for those with either a systemic or respiratory infection. Early and full intensive care treatment should be provided for these patients in order to improve the outcome.
Susiva
Chakraphan
C
Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Keeratiruangrong
Sriassancee
S
D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000592:standards*; D007902:Length of Stay; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000175:diagnosis; D017063:Outcome Assessment, Health Care; D012124:Respiratory Care Units / Q000592:standards*; D012131:Respiratory Insufficiency / Q000209:etiology / Q000401:mortality* / Q000628:therapy*; D012141:Respiratory Tract Infections / Q000209:etiology / Q000401:mortality* / Q000628:therapy*; D012189:Retrospective Studies; D017678:Sex Distribution; D016019:Survival Analysis; D013785:Thailand / Q000453:epidemiology; D016896:Treatment Outcome