Critical care management of lung cancer patients to prolong life without prolonging dying.

摘要

Over the last few decades, numerous studies showing improved short-term survival rates in critically ill patients with solid tumors or hematological malignancies have put an end to the long-accepted practice of routinely refusing admission of cancer patients to the intensive care unit (ICU) . Survival gains were demonstrated in patients with a variety of characteristics including neutropenia, severe sepsis, acute kidney injury, prolonged ICU admission and recent chemotherapy, as well as in specific subgroups of patients believed to have very low chances of survival, such as patients with lung cancer. These studies highlighted not only the beneficial impact of advances in critical care and in hematology and oncology, but also the inadequacy of our triage criteria. Furthermore, they have established that a crucial goal is the early management (and even prevention) of organ dysfunction.