[Bronchial carcinoma and intensive care].
BACKGROUND
Lung cancer is a disease with a poor prognosis. Therapeutic innovations in oncology and the optimisation of intensive care patient management have improved the prognosis of lung cancer presenting with acute life-threatening respiratory or cardiac emergencies.


METHODS
We reported on the case of a patient with lung cancer presenting with mildly abundant haemoptysis, who was hospitalised in intensive care. After multidisciplinary discussion, the patient was intubated following recurrent haemorrhage that resulted in respiratory failure. The outcome was favourable. Four months later, this patient was still alive and autonomous.


CONCLUSIONS
After years of pessimism, the medical literature has revealed an improvement in lung cancer patients' survival. Respiratory failure and shock are the main reasons for admission to the intensive care unit. The mortality risk factors depend more on acute conditions than on the underlying lung cancer. The patient's admission must be made before multiorgan failure occurs, along with the implementation of non invasive therapies. The use of intensive care as a bridge to overcome an acute event is a possible means of caring for the patient.


CONCLUSIONS
Consideration of the acute event is important when deciding whether to hospitalise a patient with lung cancer in intensive care. An early admission, if indicated, is desirable. The course in the first 72hours provides a good estimation of the patient's prognosis and helps to achieve better treatment.
Toffart
A-C
AC
Pôle médecine aiguë et communautaire, clinique de pneumologie, hôpital A.-Michalon, centre hospitalier universitaire de Grenoble, université de Grenoble, BP 217, 38043 Grenoble cedex 9, France. AToffart@chu-grenoble.fr
Pluquet
E
E
Timsit
J-F
JF
Diab
S
S
Moro-Sibilot
D
D
D018806:APACHE; D000367:Age Factors; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D003422:Critical Care; D003627:Data Interpretation, Statistical; D006801:Humans; D017567:Karnofsky Performance Status; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D013902:Radiography, Thoracic; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome