RESUMEN
INTRODUCTION: This article presents the treatment results of 320 consecutive patients with malignant haematological diagnoses admitted to a tertiary intensive care unit at a Danish University hospital over a six-year period (2005-2010). With reference to international publications, we describe the development in treatment. MATERIAL AND METHODS: This was a retrospective observational study. RESULTS: The median age was 59 years. The median intensive care unit (ICU) stay was six days. A total of 88% required mechanical ventilation, and 72% received vasopressor treatment. The median Simplified Acute Physiology Score II score was 58. The ICU and one-year mortality rates were 44% and 77%, respectively, but mortality was significantly lower for patients aged 0-20 years. For patients aged 20-80 years, the mortality risk was independent of age. For the group of patients admitted acutely to the ICU with other diagnoses, the ICU- and the one-year mortality rate was 13% and 33%, respectively. CONCLUSION: Despite progress, the mortality rate for haematological patients in ICUs is high. We lack valid tools that allow us to differentiate between those who can benefit from intensive care and those for whom transfer to an ICU is futile. One patient out of five is alive after one year. This supports a strategy offering haematological patients intensive care on an equal footing with other patients. Follow-up studies of survivors, clarification of function level and quality of life are needed. FUNDING: not relevant. TRIAL REGISTRATION: not relevant.
Asunto(s)
Cuidados Críticos/métodos , Enfermedad Crítica , Neoplasias Hematológicas/terapia , Unidades de Cuidados Intensivos/estadística & datos numéricos , APACHE , Adolescente , Adulto , Anciano , Niño , Preescolar , Dinamarca , Femenino , Neoplasias Hematológicas/diagnóstico , Neoplasias Hematológicas/mortalidad , Hematología/tendencias , Humanos , Lactante , Recién Nacido , Tiempo de Internación , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Medición de Riesgo , Triaje , Adulto JovenRESUMEN
Case report on severe hypernatraemic dehydration in a non-recognised collodion baby who also suffered from hydrops fetalis caused by supraventricular tachycardia. Excessive transcutaneous fluid loss caused s-Na+ reaching 182 mmol/l within 36 hours of birth. The infant was cautiously rehydrated during the following three days. No sign of neurologic impairment was observed. It is emphasized that early observation of the collodion baby must take place in a humidified incubator. Major weight changes in the newborn should always result in analysis of serum sodium.
