الفهرس 
PATHO--PHYSIIOLOGIICAL CHANGES THAT OCCURRED IIN PATIIENTS WIITH CANCEROnly 14 pages are availabe for public view
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Abstract
When considering all patients with cancer who require
ICU care, the most common reasons for ICU admission are:
(1) Respiratory failure
(2) Postanesthetic recovery
(3) Infection and sepsis
(4) Bleeding
(5) Oncologic emergencies.
ARF is the commonest cause for admission to the ICU in
patients with cancer and is usually associated with a poor
outcome, especially in those patients who require MV for
severe ALI.
The most frequent causes of ARF include pneumonia,
cardiogenic and noncardiogenic pulmonary edema (ALI/
ARDS), antineoplastic therapy-induced lung injury (chemotherapy,
radiation therapy), cancer-related medical disorders
(such as VTE and DAH) and direct involvement of the
respiratory system by malignancy (e.g., airway obstruction).
Pulmonary infections are the most common cause of ARF in
patients with cancer.
Patients who have cancer have a greater tendency to
acquire infections than the general population. Innate immunity dysfunction and adaptive immunity dysfunction are the major
risk factors for infections in critically ill cancer patients. The
most common organ infections in critically ill cancer patients
are respiratory infections, GIT infections including typhlitis,
CDAD and hepatosplenic candidiasis, CNS infections, CRBSI
and GU infections.
Cancer patients are at risk for several life-threatening
emergencies, including hypercalcemia, hyponatremia, HVS,
hyperleukocytosis, MSCC, brain metastases, cardiac
emergencies including SVCS, malignant pericardial effusion
and TLS and airway obstruction. Many of these high-risk
situations can be prevented or effectively managed if promptly
recognized and urgently treated,
Scoring systems used in critically ill patients can be
broadly divided into those that are specific for an organ or
disease (for example, the Glasgow Coma Scale (GCS)) and
those that are generic for all ICU patients.
And the other generic scores, which can broadly be
divided into scores that assess disease severity on admission
and use it to predict outcome (for example). Acute Physiology
and chronic Health Evaluation (APACHE), Simplified Acute
Physiology Score (SAPS), Mortality Probability Model
(MPM)), scores that assess the presence and severity of organ
dysfunction (for example, Multiple Organ Dysfunction Score (MODS), Sequential Organ Failure Assessment (SOFA), and
scores that assess nursing workload use (for example,
Therapeutic Intervention Scoring System (TISS), Nine
Equivalents of Nursing Manpower Use Score (NEMS).
Early studies of critical care outcomes in patients with
cancer describe lower survival rates in patients requiring
vasopressors، mechanical ventilation, with prolonged
neutropenia، or with septic shock. Older age was evaluated as a
potential poor prognostic variable in most studies.