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Original ArticleOpen Access
Outcome of Pediatric Oncologic Patients in the Respiratory Intensive Care Unit : Siriraj Hospital
Susiva C 
,
Keeratiruangrong S
,
Keeratiruangrong S Objectives : To review the characteristics and outcome of patients with childhood malig-
nancy requiring respiratory intensive care treatment and to assess the outcome of these patients.
Design : Retrospective review of 22 oncological patients admitted to the pediatric respi-
ratory intensive care unit between January 1, 1996 and December 31, 1998 (total 3 years.)
Results : The overall survival at discharge from the intensive care unit was 10 out of
22 (45%). The mean age of the patients was 4 years 5 months old (range 1 month to 14 years ).
Male : Female ratio was 1.2 : 1. 21 patients had fever. All patients with a systemic or respiratory
infective illness were neutropenic with a positive hemoculture in 17 out of 21 (81%) and 10 out
of 20 (50%), respectively. The most common organisms detected were coagulase negative
Staphylo-
coccal aureus
and
Escherichia Coli.
Sputum culture in the respiratory failure group was positive
in 3 out of 7 patients, all of them grew
Pseudomonas aeruginosa.
Antibiotics were given to all
oncological patients presenting with fever. The most common antibiotics administered were Cefta-
zidime, Amikacin and Imipenem. Fourteen patients needed mechanical ventilation. 11 of these 14
patients had respiratory tract infections, 1 patient had acute respiratory distress syndrome and the
remainder were in a coma as a result of brain metastasis. Only 2 of them survived. The mean dura-
tion of stay in the respiratory intensive care unit was 10.9 days.
Conclusions : There has been an improvement in the survival of oncology patients admitted
to the intensive care unit especially for those with either a systemic or respiratory infection. Early
and full intensive care treatment should be provided for these patients in order to improve the out-
come.
Key word : Intensive Care, Oncology, Infection, Survival
nancy requiring respiratory intensive care treatment and to assess the outcome of these patients.
Design : Retrospective review of 22 oncological patients admitted to the pediatric respi-
ratory intensive care unit between January 1, 1996 and December 31, 1998 (total 3 years.)
Results : The overall survival at discharge from the intensive care unit was 10 out of
22 (45%). The mean age of the patients was 4 years 5 months old (range 1 month to 14 years ).
Male : Female ratio was 1.2 : 1. 21 patients had fever. All patients with a systemic or respiratory
infective illness were neutropenic with a positive hemoculture in 17 out of 21 (81%) and 10 out
of 20 (50%), respectively. The most common organisms detected were coagulase negative
Staphylo-
coccal aureus
and
Escherichia Coli.
Sputum culture in the respiratory failure group was positive
in 3 out of 7 patients, all of them grew
Pseudomonas aeruginosa.
Antibiotics were given to all
oncological patients presenting with fever. The most common antibiotics administered were Cefta-
zidime, Amikacin and Imipenem. Fourteen patients needed mechanical ventilation. 11 of these 14
patients had respiratory tract infections, 1 patient had acute respiratory distress syndrome and the
remainder were in a coma as a result of brain metastasis. Only 2 of them survived. The mean dura-
tion of stay in the respiratory intensive care unit was 10.9 days.
Conclusions : There has been an improvement in the survival of oncology patients admitted
to the intensive care unit especially for those with either a systemic or respiratory infection. Early
and full intensive care treatment should be provided for these patients in order to improve the out-
come.
Key word : Intensive Care, Oncology, Infection, Survival
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