title: Managing the oncologic patient with suspected pneumonia in the intensive care unit.
abstract: Solid cancer patients are frequently admitted in intensive care units for critical events. Improving survival rates in this setting is considered an achievable goal today. Respiratory failure is the main reason for admission, representing a primary target for research.
  
  
  
  This review presents a diagnostic and therapeutic algorithm for pneumonia and other severe respiratory events in the solid cancer population. It aims to increase awareness of the risk factors and the different etiologies in this changing scenario in which neutropenia no longer seems to be a decisive factor in poor outcome. Bacterial pneumonia is the leading cause, but opportunistic diseases and non-infectious etiologies, especially unexpected adverse effects of radiation, biological drugs and monoclonal antibodies, are becoming increasingly frequent. Options for respiratory support and diagnostics are discussed and indications for antibiotics in the management of pneumonia are detailed. Expert commentary: Prompt initiation of critical care to facilitate optimal decision-making in the management of respiratory failure, early etiological assessment and appropriate antibiotic therapy are cornerstones in management of severe pneumonia in oncologic patients.
authors: a Infectious Disease Department , Tor Vergata University Hospital, University of 'La Sapienza' , Rome , Italy.|b Clinical Research & Innovation in Pneumonia & Sepsis (CRIPS) , Vall d'Hebron Institute of Research , Barcelona , Spain.
authors: D
authors: D
authors: Leoni
authors: b Clinical Research & Innovation in Pneumonia & Sepsis (CRIPS) , Vall d'Hebron Institute of Research , Barcelona , Spain.
authors: B
authors: B
authors: Encina
authors: b Clinical Research & Innovation in Pneumonia & Sepsis (CRIPS) , Vall d'Hebron Institute of Research , Barcelona , Spain.|c Centro de Investigación Biomédica En Red - Enfermedades Respiratorias (CIBERES) , Vall d'Hebron Institute of Research , Barcelona , Spain.|d Department of Medicine , Universitat Autònoma de Barcelona , Barcelona , Spain.
authors: J
authors: J
authors: Rello
mesh_terms: D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects; D003422:Critical Care / Q000379:methods*; D003657:Decision Making; D006801:Humans; D007362:Intensive Care Units; D009369:Neoplasms / Q000150:complications* / Q000628:therapy; D011014:Pneumonia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D017410:Practice Guidelines as Topic; D011878:Radiotherapy / Q000009:adverse effects; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents
keywords: ICU admission; Solid organ; antimicrobials; drugs and radiation; pneumonia; window of opportunity