الفهرس 
Admission Criteria and Prognosis in Patients with Cancer Admitted to the Intensive Care UnitOnly 14 pages are availabe for public view
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Abstract
When considering all patients with cancer who require ICU care, the most common reasons for ICU admission are: (1) respiratory failure, (2) postanesthetic recovery, (3) infection and sepsis, (4) bleeding, and (5) oncologic emergencies. ARF is the commonest cause for admission to the ICU in patients with cancer and is usually associated with a poor outcome, especially in those patients who require MV for severe ALI.
The most frequent causes of ARF include pneumonia, cardiogenic and noncardiogenic pulmonary edema (ALI/ ARDS), antineoplastic therapy-induced lung injury (chemotherapy, radiation therapy), cancer-related medical disorders (such as VTE and DAH) and direct involvement of the respiratory system by malignancy (e.g., airway obstruction). Pulmonary infections are the most common cause of ARF in patients with cancer.
Patients who have cancer have a greater tendency to acquire infections than the general population. Innate immunity dysfunction and adaptive immunity dysfunction are the major risk factors for infections in critically ill cancer patients. The most common organ infections in critically ill cancer patients are respiratory infections, GIT infections including typhlitis, CDAD and hepatosplenic candidiasis, CNS infections, CRBSI and GU infections.
AKI is a common complication in the critically ill cancer patients. AKI is classified according to an increase of serum creatinine or a decrease in urine output (UO) into 3 increasing severity stages: -Risk, -Injury, and Failure, or AKI stages 1 to 3. AKI may occur as a direct or indirect consequence of the cancer itself, its treatment, or associated complications. Sepsis was the most common cause of AKI followed by nephrotoxic drugs. The underlying cancer rarely may cause AKI by direct invasion of the kidney.
Cancer patients are at risk for several life-threatening emergencies, including hypercalcemia, hyponatremia, HVS, hyperleukocytosis, MSCC, brain metastases, cardiac emergencies including SVCS, malignant pericardial effusion and TLS and airway obstruction. Many of these high-risk situations can be prevented or effectively managed if promptly recognized and urgently treated.
Since the majority of deaths will occur after limiting or withdrawing life support, focus should be given to ensure that multidisciplinary family meetings are convened to discuss end-of-life decision making. The use of protocols facilitates a smooth transition and potentially reduces variability between health care providers.