Management of superior vena cava syndrome in critically ill cancer patients

Autor: Adeline Grateau, Danielle Reuter, Lara Zafrani, Sarah Morin, Cédric de Bazelaire, Benoit Schlemmer, Emmanuel Canet, Eric de Kerviler, Elie Azoulay, Constance de Margerie-Mellon
Rok vydání: 2017
Předmět:
Male
Superior Vena Cava Syndrome
Pleural effusion
medicine.medical_treatment
030204 cardiovascular system & hematology
law.invention
Hospitals
University
0302 clinical medicine
Pulmonary Embolism/pathology
law
Critical Illness/therapy
Pleural Effusion/pathology
Superior vena cava syndrome
medicine.diagnostic_test
Interventional radiology
Middle Aged
Intensive care unit
Pulmonary embolism
Intensive Care Units
Treatment Outcome
Oncology
Hematologic Neoplasms
030220 oncology & carcinogenesis
cardiovascular system
Female
medicine.symptom
Adult
Pulmonary Atelectasis
medicine.medical_specialty
Vena Cava
Superior
Critical Illness
03 medical and health sciences
Superior vena cava
medicine
Humans
cardiovascular diseases
Pulmonary Atelectasis/pathology
Hematologic Neoplasms/complications/mortality/pathology
Aged
Mechanical ventilation
business.industry
Airway obstruction
Airway Obstruction/pathology
medicine.disease
Vena Cava
Superior/pathology
Surgery
Airway Obstruction
Pleural Effusion
Pulmonary Embolism
Tomography
X-Ray Computed
business
Superior Vena Cava Syndrome/therapy
Zdroj: Supportive Care in Cancer, Vol. 26, No 2 (2018) pp. 521-528
ISSN: 1433-7339
0941-4355
DOI: 10.1007/s00520-017-3860-z
Popis: The purpose of this study is to describe the management and outcome of critically ill cancer patients with Superior Vena Cava Syndrome (SVCS). All cancer patients admitted to the medical intensive care unit (ICU) of the Saint-Louis University Hospital for a SVCS between January 2004 and December 2016 were included. Of the 50 patients included in the study, obstruction of the superior vena cava was partial in two-thirds of the cases and complete in one-third. Pleural effusion was reported in two-thirds of the patients, pulmonary atelectasis in 16 (32%), and pulmonary embolism in five (10%). Computed tomography of the chest showed upper airway compression in 18 (36%) cases, while echocardiography revealed 22 (44%) pericardial effusions. The causes of SVCS were diagnosed one (0–3) day after ICU admission, using interventional radiology procedures in 70% of the cases. Thirty (60%) patients had hematological malignancies, and 20 (40%) had solid tumors. Fifteen (30%) patients required invasive mechanical ventilation, seven (14%) received vasopressors, and renal replacement therapy was implemented in three (6%). ICU, in-hospital, and 6-month mortality rates were 20, 26, and 48%, respectively. The cause of SVCS was the only factor independently associated with day 180 mortality by multivariate analysis. Patients with hematological malignancies had a lower mortality than those with solid tumors (27 versus 80%) (odds ratio 0.12, 95% confidence interval (0.02–0.60), p
Databáze: OpenAIRE
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