Hematopoietic stem cell transplantation: implications for critical care nurses.
Hematopoietic stem cell transplantation (HSCT) is being used increasingly in the treatment of malignant and nonmalignant diseases. The treatment modality has been proven effective but is not without risks. Studies consistently have identified the need for advanced supportive care (e.g., multiple organ dysfunction, vasopressor use, mechanical ventilation) as a negative prognostic indicator in patients who have received HSCT. Among patients who have received HSCT, 15%-40% require critical care monitoring or advanced support. Nurses on intensive care units can positively impact outcomes for transplant recipients when they possess the specialized skills to recognize and promptly intervene when transplant-related complications arise. This article will provide a basic overview of the HSCT process and outline the complications that may necessitate transfer to a higher level of care for specialized skills and equipment in the intensive care setting.
Saria
Marlon G
MG
University of California, San Diego Medical Center, USA. msaria@ucsd.edu
Gosselin-Acomb
Tracy K
TK
D002983:Clinical Competence; D003422:Critical Care / Q000379:methods*; D042241:Early Diagnosis; D006086:Graft vs Host Disease / Q000209:etiology / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods / Q000451:nursing*; D006504:Hepatic Veno-Occlusive Disease / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects / Q000451:nursing; D017053:Infection Control; D008171:Lung Diseases / Q000209:etiology / Q000517:prevention & control; D008991:Monitoring, Physiologic / Q000451:nursing; D024802:Nurse's Role; D009730:Nursing Assessment; D009859:Oncology Nursing / Q000379:methods*; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000451:nursing; D016896:Treatment Outcome