Pediatric Hematologic And Oncologic Emergencies

2018 ◽  
Author(s):  
Rebecca Milligan ◽  
Jenny Mendelson
Keyword(s):  
Emergency Medicine ◽  
Immune Thrombocytopenia ◽  
Pediatric Patients ◽  
Tumor Lysis Syndrome ◽  
Von Willebrand Disease ◽  
Emergency Physicians ◽  
Tumor Lysis ◽  
Oncologic Emergencies ◽  
Life Threatening ◽  
Von Willebrand

Hematologic and oncologic emergencies that afflict children and adolescents are important for emergency medicine physicians to recognize. Pediatric patients can present with a previous formal diagnosis and have a complication related to their disease or with new symptoms that suggest a hematologic or oncologic process. Oncologic treatments can also lead to life-threatening complications. Recognizing these emergencies is very important for emergency physicians to prevent further morbidity. This review covers common patient presentations, diagnosis, and treatments for hematologic and oncologic emergencies.  This review contains 6 figures, 7 tables and 48 references Key words: hematology, hemophilia, immune thrombocytopenia, neutropenic fever, oncology, pediatric, sickle cell anemia, tumor lysis syndrome, von Willebrand disease

Pediatric Hematologic And Oncologic Emergencies

2018 ◽  
Author(s):  
Rebecca Milligan ◽  
Jenny Mendelson
Keyword(s):  
Emergency Medicine ◽  
Immune Thrombocytopenia ◽  
Pediatric Patients ◽  
Tumor Lysis Syndrome ◽  
Von Willebrand Disease ◽  
Emergency Physicians ◽  
Tumor Lysis ◽  
Oncologic Emergencies ◽  
Life Threatening ◽  
Von Willebrand

Hematologic and oncologic emergencies that afflict children and adolescents are important for emergency medicine physicians to recognize. Pediatric patients can present with a previous formal diagnosis and have a complication related to their disease or with new symptoms that suggest a hematologic or oncologic process. Oncologic treatments can also lead to life-threatening complications. Recognizing these emergencies is very important for emergency physicians to prevent further morbidity. This review covers common patient presentations, diagnosis, and treatments for hematologic and oncologic emergencies.  This review contains 6 figures, 7 tables and 48 references Key words: hematology, hemophilia, immune thrombocytopenia, neutropenic fever, oncology, pediatric, sickle cell anemia, tumor lysis syndrome, von Willebrand disease

Pediatric Hematologic And Oncologic Emergencies

2018 ◽  
Author(s):  
Rebecca Milligan ◽  
Jenny Mendelson
Keyword(s):  
Emergency Medicine ◽  
Children And Adolescents ◽  
Pediatric Patients ◽  
Emergency Physicians ◽  
Oncologic Emergencies ◽  
Life Threatening

Hematologic and oncologic emergencies that afflict children and adolescents are important for emergency medicine physicians to recognize. Pediatric patients can present with a previous formal diagnosis and have a complication related to their disease or with new symptoms that suggest a hematologic or oncologic process. Oncologic treatments can also lead to life-threatening complications. Recognizing these emergencies is very important for emergency physicians to prevent further morbidity. This review covers common patient presentations, diagnosis, and treatments for hematologic and oncologic emergencies.  This review contains 6 figures, 6 tables and 57 references

Pediatric Hematologic And Oncologic Emergencies

2018 ◽  
Author(s):  
Rebecca Milligan ◽  
Jenny Mendelson
Keyword(s):  
Emergency Medicine ◽  
Children And Adolescents ◽  
Pediatric Patients ◽  
Emergency Physicians ◽  
Oncologic Emergencies ◽  
Life Threatening

Hematologic and oncologic emergencies that afflict children and adolescents are important for emergency medicine physicians to recognize. Pediatric patients can present with a previous formal diagnosis and have a complication related to their disease or with new symptoms that suggest a hematologic or oncologic process. Oncologic treatments can also lead to life-threatening complications. Recognizing these emergencies is very important for emergency physicians to prevent further morbidity. This review covers common patient presentations, diagnosis, and treatments for hematologic and oncologic emergencies.  This review contains 6 figures, 6 tables and 57 references

Hematologic and Oncologic Emergencies

2019 ◽  
pp. 170-177
Author(s):  
James McCue
Keyword(s):  
Emergency Department ◽  
Standardized Tests ◽  
Tumor Lysis Syndrome ◽  
Clinical Effects ◽  
Tumor Lysis ◽  
Oncologic Emergencies ◽  
First Response ◽  
Appropriate Treatment ◽  
Wide Range ◽  
Life Threatening

Hematologic and oncologic emergencies are an uncommon reason for people to present to the emergency department (ED), but when they do, it is important to know how to diagnose and treat these conditions because many of them are life threatening. Whether it is bleeding due to conditions such as hemophilia, von Willebrand’s disease, warfarin use, or dangerous conditions related to cancer such as tumor lysis syndrome or neutropenic fever, knowing the basics will help you manage these patients and also ace the standardized tests. This chapter presents questions related to the diagnosis, clinical effects, best first response in the ED, and most appropriate treatment of a wide range of these hematologic and oncologic emergencies.

Economic comparison of rasburicase and allopurinol for treatment of tumor lysis syndrome in pediatric patients

2010 ◽  
Vol 67 (24) ◽  
pp. 2110-2114 ◽  
Author(s):  
Michael Eaddy ◽  
Brian Seal ◽  
Muralikrishna Tangirala ◽  
Elizabeth Hackney Davies ◽  
Ken O’Day
Keyword(s):  
Pediatric Patients ◽  
Tumor Lysis Syndrome ◽  
Tumor Lysis ◽  
Economic Comparison

scholarly journals The Domino Effect-Treatment of Superior Vena Cava Obstruction Triggering Tumor Lysis Syndrome: A Case Report

2021 ◽  
Vol 3 (1) ◽  
pp. 44-50
Author(s):  
Suman Ghosh ◽  
Tilak TVSVGK ◽  
Venkatesan Somasundaram ◽  
Mutreja Deepti
Keyword(s):  
Superior Vena Cava ◽  
Lymphoblastic Leukemia ◽  
Superior Vena ◽  
Tumor Lysis Syndrome ◽  
Vena Cava ◽  
Potassium Phosphate ◽  
Successful Outcome ◽  
Superior Vena Cava Obstruction ◽  
Tumor Lysis ◽  
Life Threatening

Oncological emergencies present in a multitude of manners-structural, metabolic, hematologic, etc. affecting multiple systems, often. Urgent institution of therapy is often required for a successful outcome. Occasionally, the treatment of one emergency can initiate a related or unrelated emergency, necessitating management of all the complications simultaneously. Superior vena cava obstruction (SVCO) is a medical emergency and most often manifests in patients with a malignant disease process requiring immediate diagnostic evaluation and therapy due to its’ life threatening presentation. The management of the SVCO is usually with chemotherapy, radiotherapy or intervention. In cases of large tumor burden, management of SVCO can trigger other complications. Tumor lysis syndrome is an oncologic emergency, which is characterized by a massive release of intracellular potassium, phosphate, and nucleic acid metabolites into the systemic circulation, which can be life-threatening. We present the case of a T-cell acute lymphoblastic leukemia with superior vena cava syndrome, developing tumor lysis syndrome on instituting definitive chemotherapy in a young patient. Doi: 10.28991/SciMedJ-2021-0301-6 Full Text: PDF

Oncologic Emergencies

2011 ◽  
Vol 22 (4) ◽  
pp. 337-348 ◽  
Author(s):  
Regan Demshar ◽  
Rachel Vanek ◽  
Polly Mazanec
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Superior Vena ◽  
Tumor Lysis Syndrome ◽  
Vena Cava ◽  
Hemodynamic Instability ◽  
Cord Compression ◽  
Current Evidence ◽  
Oncologic Emergencies ◽  
Life Threatening

The picture of oncologic emergencies in the intensive care unit has changed over the past decade. The classic emergencies, that is, superior vena cava syndrome, spinal cord compression, tumor lysis syndrome and life-threatening hypercalcemia, are now routinely managed on the general oncology unit or in an outpatient setting. Vigilant monitoring for early signs of complications, proactive interventions to prevent complications, and aggressive management account for this change. Currently, emergent conditions that necessitate intensive care unit admission or transfer in the patient with cancer include respiratory failure, cardiac emergencies, hemorrhagic events and coagulopathies, sepsis, and hemodynamic instability. This article will present the current evidence-based management of these conditions, a brief summary of classic oncologic emergencies, and the role of the critical care nurse in meeting the multidimensional needs of the patient and family during the life-threatening episode, based on Ferrell’s quality of life model.

scholarly journals Prevention and Treatment of Tumor Lysis Syndrome in the Era of Onco-Nephrology Progress

2020 ◽  
Vol 45 (5) ◽  
pp. 645-660
Author(s):  
Joanna Matuszkiewicz-Rowinska ◽  
Jolanta Malyszko
Keyword(s):  
High Risk ◽  
Treatment Plan ◽  
Diuretic Therapy ◽  
Tumor Lysis Syndrome ◽  
Phosphate Binders ◽  
Tumor Lysis ◽  
Threatening Condition ◽  
Clinical Consequences ◽  
Life Threatening ◽  
Knowledge Of Cancer

Background: Tumor lysis syndrome (TLS) is an oncologic emergency due to a rapid break down of malignant cells usually induced by cytotoxic therapy, with hyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia, and serious clinical consequences such as acute renal injury, cardiac arrhythmia, hypotension, and death. Rapidly expanding knowledge of cancer immune evasion mechanisms and host-tumor interactions has significantly changed our therapeutic strategies in hemato-oncology what resulted in the expanding spectrum of neoplasms with a risk of TLS. Summary: Since clinical TLS is a life-threatening condition, identifying patients with risk factors for TLS development and implementation of adequate preventive measures remains the most critical component of its medical management. In general, these consist of vigilant laboratory and clinical monitoring, vigorous IV hydration, urate-lowering therapy, avoidance of exogenous potassium, use of phosphate binders, and – in high-risk cases – considering cytoreduction before the start of the aggressive agent or a gradual escalation of its dose. Key Messages: In patients with a high risk of TLS, cytotoxic chemotherapy should be given in the facility with ready access to dialysis and a treatment plan discussed with the nephrology team. In the case of hyperkalemia, severe hyperphosphatemia or acidosis, and fluid overload unresponsive to diuretic therapy, the early renal replacement therapy (RRT) should be considered. One must remember that in TLS, the threshold for RRT initiation may be lower than in other clinical situations since the process of cell breakdown is ongoing, and rapid increases in serum electrolytes cannot be predicted.

PFA-100 closure times in preoperative screening in 500 pediatric patients

2007 ◽  
Vol 98 (07) ◽  
pp. 243-247 ◽  
Author(s):  
Birgit Roschitz ◽  
Sigrid Thaller ◽  
Martin Koestenberger ◽  
Andrea Wirnsberger ◽  
Bettina Leschnik ◽  
...  
Keyword(s):  
Blood Cell ◽  
Bleeding Complication ◽  
Pediatric Patients ◽  
Screening Method ◽  
Outpatient Service ◽  
Von Willebrand Disease ◽  
Preoperative Screening ◽  
Blood Cell Count ◽  
Specific Diagnosis ◽  
Von Willebrand

SummaryThree to five percent of patients undergoing surgery have either an acquired or congenital platelet defect or von Willebrand disease (vWD). The predictive value of preoperative coagulation screening is questionable. PFA-100 is now routinely used in preoperative screening in our pediatric outpatient service. We wanted to assess whether the PFA-100 would help to identify patients with primary haemostatic defects or if the additional use of PFA-100 would add to the problem of unnecessary pathologic preoperative laboratory values resulting in delay of surgical procedure. We investigated 500 children consecutively seen in our outpatient service before surgery. Blood cell count, aPTT, PFA-100 closure times (CT) were done in all patients. If abnormalities were found, the patient was presented to a haemostatic expert. vWF:AG, R:Cof and factorVIII were analysed in all patients with prolonged closure times and APTT values. One hundred twenty-six patients (25.2%) showed abnormalities in APTT and/or PFA-100. Further investigations in 89 of these 126 patients did not yield a specific diagnosis; neither diagnostic criteria for impaired haemostasis were found by questionnaire. None of these 89 patients had a bleeding complication during surgery. Forty-eight patients showed prolonged CTs. Twelve patients with low vWF:AG were detected, 10 of these patients were found by PFA-100. Four of these patients did present with normal APTT values. Our study shows that similar to the APTT the PFA-100 is probably only a good screening method when a haemostatic defect in a patient is clinically likely, especially to screen forVWD, and the test should not be used in general unselective screening.

Oncologic Emergencies (DRAFT)

2018 ◽  
Author(s):  
Harry S. Rafkin
Keyword(s):  
Superior Vena ◽  
Tumor Lysis Syndrome ◽  
Vena Cava ◽  
Cord Compression ◽  
Initial Assessment ◽  
High Morbidity ◽  
Patients With Cancer ◽  
Oncologic Emergencies ◽  
Life Threatening ◽  
Vena Cava Syndrome

Oncologic emergencies are potentially life-threatening syndromes that occur in patients with cancer, and are either directly or indirectly related to the patient’s tumor. The clinical progression of these syndromes is rapid and the initial assessment of the patient must be done quickly, as without immediate therapy, high morbidity and mortality results. The oncologic emergency may be due to the tumor, the treatment given to control the tumor, or it may be due to a previously existing condition. This chapter reviews the clinical presentation, treatment, and management of tumor lysis syndrome, hypercalcemia, hyponatremia, disseminated intravascular coagulation, hyperviscosity syndrome, spinal cord compression, and superior vena cava syndrome.

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