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Management of unstable pediatric hemato-oncology patient: results of a web-based survey to pediatric oncologists in Spain.
MedLine Citation:
PMID:  23015044     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The current management and monitoring of unstable pediatric hemato-oncology patient (UPHOP) in the oncology ward is not well defined. To evaluate this concept, an anonymous Web-based survey was sent to the 150 Spanish pediatric oncologists registered in the Spanish Society of Pediatric Hemato-Oncology. The response rate was 57 %, with the following main results: Pediatric intensive consulting was available for 97 %, and it was made in case of UPHOP by 37 % of oncologists, up to 65 % if hemodynamic instability. In case of inotropic support initiation, 32 % of respondents never consulted the intensivist. Dopamine is first chosen inotropic; 28 % of surveyed considered there is no limit in its dosage or it is superior to 20 μg/kg/min before an intensivist consulting. Pediatric intensive care admission was considered necessary in case of fever with hemodynamic instability by 15 % of respondents. Respiratory monitoring was mainly done by clinical signs (67 %). In case of respiratory insufficiency, the noninvasive respiratory support by high-flow ventilation with nasal cannula was applied by 57 % in the oncology ward. In case of acute kidney injury, diuretics were generally the initial therapy. The anticonvulsive drugs most frequently applied were valproic acid (93 %), diazepam (88 %), and phenytoin (81 %). Conclusion: A consensus should be achieved among oncologists and intensivists. The creation and training of rapid response teams could be useful to improve the UPHOP management.
Authors:
Alberto García-Salido; María Isabel Iglesias-Bouzas; Montserrat Nieto-Moro; Alvaro Lassaleta-Atienza; Ana Serrano-González; Juan Casado-Flores
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-27
Journal Detail:
Title:  European journal of pediatrics     Volume:  -     ISSN:  1432-1076     ISO Abbreviation:  Eur. J. Pediatr.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603873     Medline TA:  Eur J Pediatr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Pediatric Critical Care Unit, Hospital Infantil Universitario Niño Jesús, Avenida Menéndez Pelayo 65, Madrid, Spain, citopensis@yahoo.es.
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