Ebook Handbook of critical and intensive care medicine (3/E): Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Handbook of critical and intensive care medicine (3/E): Part 2
Ebook Handbook of critical and intensive care medicine (3/E): Part 2
11Critical Care OncologyCancer is becoming the leading cause of death in the United States. Enhanced critical care capabilities have contributed subst Ebook Handbook of critical and intensive care medicine (3/E): Part 2tantially to improved survival. Critical care may be needed on a short-term basis for the complications of the underlying malignancy or of aggressive antineoplastic therapy. Postoperative critical care has greatly facilitated major extirpative cancer surgery' and is an implicit part of other approac Ebook Handbook of critical and intensive care medicine (3/E): Part 2hes such as bone marrow transplantation.Patients with cancer may require 1CU care at some point in their illness. This could be directly associated wiEbook Handbook of critical and intensive care medicine (3/E): Part 2
th malignancy (i.e.. acute pulmonary' embolism). In addition, admission to the ICƯ can be treatment related (i.c.. cell toxicity), and it can also be 11Critical Care OncologyCancer is becoming the leading cause of death in the United States. Enhanced critical care capabilities have contributed subst Ebook Handbook of critical and intensive care medicine (3/E): Part 2ma, and lung cancer. Early admission to the ICU increases the opportunity to prevent or treat cancer-related complications, such as leukostasis. multiple organ dysfunction, tumor lysis syndrome, and macrophage lysis syndrome.The present chapter considers different types of cancer patients likely to Ebook Handbook of critical and intensive care medicine (3/E): Part 2need and benefit from treatment in the ICU. Clinical judgment regarding the appropriate use of critical care services is required in all patient populEbook Handbook of critical and intensive care medicine (3/E): Part 2
ations, not just in patients with cancer. The decision to admit and technologically support critically ill cancer patients should be individualized.■ 11Critical Care OncologyCancer is becoming the leading cause of death in the United States. Enhanced critical care capabilities have contributed subst Ebook Handbook of critical and intensive care medicine (3/E): Part 2 patients in the intensive care unit (1CU). The common differential diagnoses are considered below. If these can be excluded and the patient has not received excessive sedative or narcotic-analgesic agents, the patient should be treated presumptively for sepsis. Altered mentalc Springer Internationa Ebook Handbook of critical and intensive care medicine (3/E): Part 2l Publishing Switzerland 201624411. Critical Care Oncologystatus is a reliable, though nonspecific, sign of sepsis, which carries a high mortality ratEbook Handbook of critical and intensive care medicine (3/E): Part 2
e in cancer patients.1.Intracranial Mass LesionsA history of headache, nausea, vomiting, or seizure activity together with papilledema and other signs11Critical Care OncologyCancer is becoming the leading cause of death in the United States. Enhanced critical care capabilities have contributed subst Ebook Handbook of critical and intensive care medicine (3/E): Part 2ted; however, when intracranial pressure becomes critical, brain substance will shift in the direction of least resistance, with resultant herniation through the tentorium or foramen magnum.2.Primary Tumors of the CNSThese present with focal neurologic signs, depending on location.3.Secondary (Metas Ebook Handbook of critical and intensive care medicine (3/E): Part 2tatic) TumorsApproximately 15-30% of secondary tumors will present with new-onset seizures. Common malignancies associated with cerebral metastases inEbook Handbook of critical and intensive care medicine (3/E): Part 2
clude breast, lung, kidney, and melanoma.4.Cerebral 1 lemorrhagcCerebral hemorrhage is associated with acute promyclocytic leukemia, as a direct compl11Critical Care OncologyCancer is becoming the leading cause of death in the United States. Enhanced critical care capabilities have contributed subst Ebook Handbook of critical and intensive care medicine (3/E): Part 2ness and hemiparesis.6.Brain AbscessBrain abscess accounts for 30% of CNS infections in cancer patients.(a)Clinically apparent raised intracranial pressure and neurologic deficits are late signs.(b)Usually present with fever, headache, drowsiness, confusion, and seizures.(c)Typically seen in patient Ebook Handbook of critical and intensive care medicine (3/E): Part 2s with leukemias or head and neck tumors.B. Other Causes of Altered Mental Status in Critically Ill Cancer Patients1.Leptomeningeal Metastases(a)May pEbook Handbook of critical and intensive care medicine (3/E): Part 2
resent with signs of raised intracranial pressure and hydrocephalus.(b)Acute leukemias, lymphomas, and breast carcinomas are frequent causes.2.Cerebro11Critical Care OncologyCancer is becoming the leading cause of death in the United States. Enhanced critical care capabilities have contributed subst Ebook Handbook of critical and intensive care medicine (3/E): Part 2ts present with focal neurologic signs and headaches.(b)Seizures are common, especially in hemorrhagic CVA.(c)Embolic CVA in cancer patients may be related to septic emboli, especially in patients with known fungal infection (i.e.. aspergillosis).3.Metabolic EncephalopathiesLethargy, weakness, somno Ebook Handbook of critical and intensive care medicine (3/E): Part 2lence, coma, agitation or psychosis, and focal or generalized seizures can all result from metabolic abnormalities. Lack of focal neurologic signs sugEbook Handbook of critical and intensive care medicine (3/E): Part 2
gests a metabolic encephalopathy. Examples include:(a)Hypercalcemia (sec below)11Critical Care OncologyCancer is becoming the leading cause of death in the United States. Enhanced critical care capabilities have contributed subst11Critical Care OncologyCancer is becoming the leading cause of death in the United States. Enhanced critical care capabilities have contributed substGọi ngay
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