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Critical Care of the Pediatric Immunocompromised Hematology/Oncology Patient pp 3–7Cite as

The Changing Landscape of the Critical Care of Pediatric Immunocompromised Hematology and Oncology Patients

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Abstract

Immunocompromised children and adolescent patients who have hematologic or oncologic diseases represent a small percentage of patients treated in pediatric intensive care units (PICUs) but have a disproportionately high mortality rate. A single-center study of 1278 patients admitted to a pediatric hematology-oncology service over an 11-year period found an admission rate of 4.2% with an overall PICU mortality rate of 38.9% (Faraci et al. J Pediatr Hematol Oncol 36(7): e403–9, 2014). Risk factors for PICU admission included older age, diagnosis of nonmalignant disease, and treatment with HCT. A more recent retrospective multicenter cohort analysis of almost 250,000 consecutive PICU admissions using the Virtual PICU Systems database identified 10,365 patients diagnosed with a malignancy who were admitted to PICUs for reasons other than perioperative admissions during the study period (Zinter et al. Intensive Care Med 40(10): 1536–44, 2014). Children with any cancer accounted for 11.4% of all PICU deaths and had mortality of 6.8% (43% in those who were mechanically ventilated) compared to 2.4% in patients without malignancy.

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Authors and Affiliations

  1. Pediatric Hematology-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA

    Christine N. Duncan

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  1. Christine N. Duncan
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Correspondence to Christine N. Duncan .

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Editors and Affiliations

  1. Pediatric Hematology-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA

    Christine N. Duncan

  2. Children’s Hospital of Wisconsin-Milwaukee, Medical College of Wisconsin, Milwaukee, WI, USA

    Julie-An M. Talano

  3. Department of Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Jennifer A. McArthur

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Duncan, C.N. (2019). The Changing Landscape of the Critical Care of Pediatric Immunocompromised Hematology and Oncology Patients. In: Duncan, C., Talano, JA., McArthur, J. (eds) Critical Care of the Pediatric Immunocompromised Hematology/Oncology Patient. Springer, Cham. https://doi.org/10.1007/978-3-030-01322-6_1

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  • DOI: https://doi.org/10.1007/978-3-030-01322-6_1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-01321-9

  • Online ISBN: 978-3-030-01322-6

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