Prognostic Value of Some Characteristic Sings in Patients with Haematologic Malignity in Intensive Care

Czech version

Authors: M. Kolár ¹; M. Balík ¹; M. Marková ²; E. Zikešová ³
Authors‘ workplace: Anesteziologicko-resuscitacní klinika, FN Královské Vinohrady, Praha, prednosta doc. MUDr. Jan Pachl, CSc. 2 Ústav hematologie a krevní transfuze, Praha, prozatímní vedoucí prof. MUDr. J. Klenner, DrSc. 3 Hematologické oddelení FN Královské Vinohrady, Pra ¹
Published in: Anest. intenziv. Med., , 2002, č. 3, s. 115-118
Category:

Overview

The aim of study was evaluation of the prognostic factors in critically ill patients with haematologic malignity. 39 patients were enrolled in the study.Detailed evaluation is made from data of 24 patients without bone marrow transplantation. The bone marrow transplanted patients were subject ofanother study. All the patients came from the Department of Haematology of University Hospital Královské Vinohrady and the Institue of Haematologyand Blood Transfusion. The patients were admitted to the intensive care unit in the Department of Anaesthesiology and Intensive Care of UniversityHospital Královské Vihohrady between January 1999 and December 2000. The authors performed an open and retrospective analysis. The results arepresented in primary form due to the small number of patients. The important factors of prognostic value were: complication which caused the staterequiring intensive care (pneumonia has better prognosis than sepsis from other locality), duration of severe leukopenia in critically ill patient(leukopenia, i.e. white blood cells < 1000/mm 3 , for more than 7 days was associated with adverse prognosis) and the extent of multiorgan failure –MOF (patients with more than 4 organ systems failed had little chance to survive). The authors did not show the association between survival ormortality and the type of haematologic malignity. With careful indication for admitting the patient to the intensive care unit, i.e. elimination of patientsin terminal and non-curable stage of basic disease, the overall prognosis can be surprisingly favourable. In this study 50 %patients survived the criticalcomplication which required intensive care. Long-term survival rate after that complication is 25 % so far. The authors emphasize the importance ofearly initiation of positive pressure ventilation as the prevention of systemic hypoxia.

Key words:
patient with haematologic malignity – critical state – sepsis – leukopenia – multiorgan failure (MOF)

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