Critically ill patients with cancer: chances and limitations of intensive care medicine—a narrative review

• Published in: ESMO open 2016, Vol.1 (5), p.e000018-e000018, Article e000018
• Main Authors: Schellongowski, Peter, Sperr, Wolfgang R, Wohlfarth, Philipp, Knoebl, Paul, Rabitsch, Werner, Watzke, Herbert H, Staudinger, Thomas
• Format: Article
• Language: English
• Subjects: admission criteria; cancer; intensive care unit; palliative care; Review
• ISSN: 2059-7029; 2059-7029
• DOI: 10.1136/esmoopen-2015-000018

This narrative review deals with the challenge of defining adequate therapy goals and intensive care unit (ICU) admission criteria for critically ill patients with cancer. Several specific complications of critically ill patients with cancer require close collaborations of intensive care and cancer specialists. Intensivists require a basic understanding of the pathophysiology, diagnosis and therapy of common cancer-specific problems. Cancer specialists must be knowledgeable in preventing, detecting and treating imminent or manifest organ failures. In case of one or more organ dysfunctions, ICU admissions must be evaluated early. In order to properly define the therapy goals for critically ill patients with cancer, decision-makers must be aware of the short-term intensive care prognosis as well as the long-term oncological options and perspectives. Multidisciplinary teamwork is key when it comes down to decisions on ICU admission, planning of therapeutic aims, patient management in the ICU and tailored therapy limiting with smooth transition into a palliative care (PC) setting, whenever appropriate.