Patients with cancer admitted to the ICU. No intervention will be administered.

There will be no change in the standard ICU treatment.

Cancer patients admitted to the ICU

Sebastián Mondaca, MD

The purpose of this study is to determine 30 day mortality in cancer patients admitted to the intensive care unit in a resource limited setting.

The management of cancer patients in the intensive care unit (ICU) has changed dramatically during the last two decades. Initial experiences showed high rates of hospital mortality, reaching up to 75-85% in patients requiring life-sustaining treatments, particularly mechanical ventilation. An increasing number of clinical experiences has been reported pointing to a significant improvement in survival of these patients. However, it is not clear if this results are generalizable to settings with resource constraints. Therefore, the purpose of this study is to determine 30 day mortality in cancer patients admitted to the intensive care unit in a resource limited setting.

This study is a prospective cohort of cancer patients admitted to the ICU in which the investigators will evaluate the prognostic of cancer patients admitted for a ICU trial or treatment in ICU without limitations. This study will not consider any change in the treatment plan of the patients. The source of the data will be the clinical records of the patients during the admission and the records of the cancer unit. There will be no direct contact of the research team with the patients or their family.

Mortality in Cancer Patients Admitted to the Intensive Care Unit in a Resource-limited Setting

Mortality in Cancer Patients Admitted to the Intensive Care Unit in a Resource-limited Setting: A Prospective Cohort Study

Pontificia Universidad Catolica de Chile

Symptoms and General Pathology

All Conditions

Critical Illness

Disease Attributes

All Drugs and Chemicals

Immunomodulating Agents

Anne-Claire TOFFART, MD-PhD

This work aims to describe the characteristics and methods of management of patients suffering from a solid tumor treated with immunotherapy admitted to intensive care.

The place of checkpoint inhibitors (anti-PD-1 and PD-L-1) is currently validated in the management of melanoma and metastatic non-small cell lung cancer. The toxicity profile is specific with adverse effects related to immunity. Some side effects (myocarditis, colitis, interstitial lung disease, etc.) can be severe and patient could be hospitalized in intensive care unit.

The question of immunotherapy's imputability in the acute disease is becoming more frequent.

Cancer Patients Treated With Immunotherapy in Intensive Care Unit

Characteristics and Care of Solid Tumor Patients Treated With Immunotherapy Admitted in Intensive Care Unit.

Description of ICU admission reason (immunotherapy toxicity versus other) for lung cancer patients treated by immunotherapy

immunosuppressive treatments in intensive care unit

Jules Bordet Institute

University Hospital, Grenoble

Respiratory Tract (Lung and Bronchial) Diseases

Neoplasms

Blood and Lymph Conditions

Rare Diseases

Respiratory Insufficiency

Hematologic Neoplasms

Respiration Disorders

Respiratory Tract Diseases

Hematologic Diseases

Acute Graft Versus Host Disease

requiring mechanical ventilation at admission to ICU for one day or more during the study period

Mechanical ventilation

Dr.Enas A Abd El motlb, MD

This observational cohort aimed to re-evaluate the outcome of hematologic cancer patients admitted to the intensive care unit of Mansoura oncology center through a cohort study as regards their need for mechanical ventilation during two years.

It has been believed for many years that the scene of cancer patients requiring mechanical ventilation is frustrating. The needed life support measures drain much of health resources and add a significant burden on the patient's family. Many factors have been responsible for the high mortality rates among hematologic cancer patients admitted to intensive care unit. Among of these factors, the invasive treatments that are frequently employed in today's intensive care unit. These procedures give chance for development of severe infection and multiple organ failure which are common events in immune-compromised patients (e.g. neutropenia) and in those exposed to chemotherapy. The most common form of organ failure in those patients is acute respiratory failure which is a major predictor of mortality in that population. The prognosis of such failure may vary depending on its causes and severity, co morbidity, associated acute organ failure and characters of the underlying malignancy. After the recent advances in the field of intensive care and shedding light on the benefits of the noninvasive ventilation in immune-compromised patients, the overall survival rate of cancer patients admitted to intensive care unit are improving.

Prognosis of Hematological Cancer Patient Underwent Mechanical Ventillation

In a Developing Country; What is the Fate of Hematologic Cancer Patients Requiring Mechanical Ventilation for More Than One Day? A Prospective Cohort Study

Like as sepsis, acute respiratory distress syndorme, or leukopenia

Sequential Organ Failure Assessment (SOFA) Score

Simplified Acute Physiology Score (SAPS II)

synchronised intermittent, pressure-controlled, volume-controlled, pressure support, continuous positive airway pressure, volume guarantee, adjusted pressure release ventilation, or adaptive proportional assist ventilation

PaO2 "arterial oxygen tension"/FiO2 "inspired fraction of oxygen" ratio

Advanced malignancy, respiratory muscle weakness, respiratory failure, lung metastasis, coma, sepsis, multi-organs failure

Mansoura University

Assistant professor

Retrospective study of ICU admissions of hematology patients for respiratory and hemodynamic reasons Time period: January 2012 to March 2017

Corresponding to the period after the implementation of a systematic intensivist evaluation Daily screening of systolic blood pressure, oxygen saturation and oxygen requirements of all patients hospitalized in hematology wards. Systematic evaluation of any patient presenting the inclusion criteria by an intensivist and collegial care planning.

Time period: From March 2017 to end of study

implementation of a standardized procedure for patient care in ICU

Systematic evaluation by an intensivist

Nicolas Terzi

Over the last two decades, the number of patients with hematological malignancies (HMs) admitted to the ICU increased and their mortality has dropped sharply. Patients with HMs increasingly require admission to the intensive care unit (ICU) for life-threatening events related to the malignancy and/or treatments, with immunosuppression being a major contributor. Whether the increase in ICU admissions is related to increased referrals by hematologists and/or to increased admissions by intensivists is unknown. The criteria used for ICU referral and admission decisions have not been extensively evaluated. Finally, the links between admission policies and treatment-limitation decisions are unclear, but ICUs with broad admission policies may change the treatment goals based on the response to several days of full-code management.

The aim of this study is to evaluate the impact of a systematic evaluation by an intensivist of HMs patients presenting with acute respiratory and/or hemodynamic failure.

Systematic Evaluation by an Intensivist of Hematological Malignancy Patients Presenting With Acute Respiratory or Hemodynamic Failure

Systematic Evaluation by an Intensivist of Hematological Malignancy Patients Presenting With Acute Respiratory or Hemodynamic Failure: Impact on Prognosis: A Monocentric Observational Before-after Study

difference between the Sepsis-related Organ Failure Assessment score between 48h and 72h after ICU admission and the SOFA score during the first 24h.

SOFA score ranges from 0 to 20 delta SOFA= SOFA day 3 - SOFA day1

survival status (alive/dead) at one year after ICU admission

survival status (alive/dead) at the end of the ICU stage

survival status (alive/dead) at the end of the hospitalization

Delay between the start of critical care illness and ICU admission Delay is measured in minutes

Number of days with mechanical ventilation

Number of days with non-invasive ventilation

Number of days with renal replacement therapy

status of hematological primary disease at death or after one year of evolution if the patient is still alive. Possible status of hematology disease : complete remission, partial remission, stability, relapsed/refractory.

EQ5-D assessment of patients' quality of life one year after Intensive care unit admission

Infections

COVID-19

all consecutive patients diagnosed with HM and admitted to both ICUs between January 2009 and December 2019.

no intervention

The investigators sought to report the outcomes of patients with haematological malignancies admitted to the intensive care units and to define pre-intensive care units prognostic factors for in-hospital all-cause mortality.

In this retrospective, single-center study, all patients with haematologic malignancies admitted to intensive care units between 2009 and 2019 were included. The primary outcome was in-hospital mortality.

The study was performed at the SUMC, an academic tertiary medical center serving the entire southern district of Israel. Our hospital operates two ICUs: an 8-bed medical ICU and a 16-bed surgical ICU. A senior intensivist and haematologist are available 24 hours every day for clinical decision-making at both units.

The investigators conducted a retrospective cohort study of all consecutive patients diagnosed with HM and admitted to both ICUs between January 2009 and December 2019. The inclusion criteria were a diagnosis of HM on admission or discharge from the ICU. Patients under 18 years of age or who were completely cured of malignancy for more than five years were excluded. Patients admitted to the ICU during the COVID-19 pandemic were also excluded to avoid biases caused by resource accessibility in terms of ICU beds and qualified teams.

The investigators collected data from the hospital's electronic medical records, including demographic data, medical history, and comorbidities, as coded by the International Classification of Diseases (ICD)-9.

Haematological malignancy diagnoses were categorized into five major groups: acute leukemia, aggressive non-Hodgkin lymphoma, Hodgkin lymphoma, multiple myeloma, and others. The remission status, post haematopoietic cell transplantation status (allogeneic or autologous), and date of the last chemotherapy or biological treatment were collected.

Clinical pre-ICU admission parameters, including vital signs, complete blood count, absolute neutrophil counts, lactate dehydrogenase (LDH) levels, liver enzymes, urea and creatinine levels, electrolytes, pH and lactate levels, and coagulation parameters, were recorded at ICU admission. Moreover, the ICU admission Sepsis-Related Organ Failure Assessment (SOFA) score 20 and the acute physiology and chronic health evaluation (APACHE) II severity of disease classification system 21 were recorded, to provide prognostic evidence-based references.

Clinical parameters during ICU admission included treatment with vasopressor medications, the level of respiratory support needed (nasal cannula/reservoir mask/noninvasive ventilation/invasive mechanical ventilation support), the need for renal replacement therapy, and liver dysfunction, defined by the elevation of liver enzymes and bilirubin.

The definition of organ dysfunction during ICU admission included the need for mechanical ventilation, vasopressor treatment, renal replacement therapy, elevated bilirubin \>2 mg/dl or newly reduced left ventricular function (defined as an ejection fraction \<30%).

Outcomes of Critically Ill Patients With Hematologic Malignancies

Outcomes of Non-COVID-19 Critically Ill Patients With Hematologic Malignancies

Soroka University Medical Center

senior physician, head of ECMO service SUMC

Lung Neoplasms

Emergencies

Inflammation

Respiratory Tract Neoplasms

Thoracic Neoplasms

Lung Diseases

Lung neoplasms irrespective of stage and histology

Anne-Pascale Meert, MD, PhD

Systemic inflammation is a potential prognostic factor in cancer. Inflammation scores as the Glasgow score have been tested in cancer and specifically in lung cancer patients. The aim of the study is to look at the prognostic and predictive value of inflammation during cancer evolution, on the risk of complications leading to ICU admission and the risk of death.

Patients with newly diagnosed lung cancer will be eligible. All patients will have a blood sampling allowing testing inflammation and cytokine analyses at diagnosis, during work-up and in case of complication.

Has Inflammation a Significant Implication in Lung Cancer Evolution?

L'Inflammation A-t-elle Une Implication Significative Dans l'évolution du Cancer Bronchique?

Recording any complication leading to consultation at the emergency department or admission into the intensive care unit

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Mortality in Cancer Patients Admitted to the Intensive Care Unit in a Resource-limited Setting	NCT02659839	Cancer	Cancer patients...	18 Years -	Pontificia Universidad Catolica de Chile
Cancer Patients Treated With Immunotherapy in Intensive Care Unit	NCT03357861	Cancer Critical Illnes... Immunotherapy		18 Years -	University Hospital, Grenoble
Mortality in Cancer Patients Admitted to the Intensive Care Unit in a Resource-limited Setting	NCT02659839	Cancer	Cancer patients...	18 Years -	Pontificia Universidad Catolica de Chile
Prognosis of Hematological Cancer Patient Underwent Mechanical Ventillation	NCT02562105	Hematological M... Acute Respirato... Mechanical Vent...	Mechanical vent...	18 Years - 75 Years	Mansoura University
Systematic Evaluation by an Intensivist of Hematological Malignancy Patients Presenting With Acute Respiratory or Hemodynamic Failure	NCT03399149	Respiratory Ins... Hematologic Mal...	Systematic eval...	18 Years -	University Hospital, Grenoble
Mortality in Cancer Patients Admitted to the Intensive Care Unit in a Resource-limited Setting	NCT02659839	Cancer	Cancer patients...	18 Years -	Pontificia Universidad Catolica de Chile
Systematic Evaluation by an Intensivist of Hematological Malignancy Patients Presenting With Acute Respiratory or Hemodynamic Failure	NCT03399149	Respiratory Ins... Hematologic Mal...	Systematic eval...	18 Years -	University Hospital, Grenoble
Prognosis of Hematological Cancer Patient Underwent Mechanical Ventillation	NCT02562105	Hematological M... Acute Respirato... Mechanical Vent...	Mechanical vent...	18 Years - 75 Years	Mansoura University
Cancer Patients Treated With Immunotherapy in Intensive Care Unit	NCT03357861	Cancer Critical Illnes... Immunotherapy		18 Years -	University Hospital, Grenoble
Outcomes of Critically Ill Patients With Hematologic Malignancies	NCT06410066	Hematologic Mal...	no intervention	18 Years - 100 Years	Soroka University Medical Center
Has Inflammation a Significant Implication in Lung Cancer Evolution?	NCT02484872	Lung Neoplasms		18 Years -	European Lung Cancer Working Party

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