Improved outcomes of children with malignancy admitted to a pediatric intensive care unit

Objective: To assess the acute and long-term outcomes of children admitted to the intensive care unit with cancer or complications after bone marrow transplantation. Design: Retrospective analysis of databases from a prospective pediatric intensive care unit (PICU) database supplemented by case notes review. Setting: A PICU in a tertiary pediatric hospital. Patients: All children with malignancy admitted to the PICU between May 1, 1987, and April 30, 1996. Interventions: None. Measurements and Main Results: There were 206 admissions to the PICU during a 9-yr study period of 150 children with malignancies or complications after bone marrow transplantation. Forty patients died in the PICU (27% mortality rate). The most frequent indications for PICU admission were shock and respiratory disease. Of 56 children admitted with shock, there were 16 deaths (29% mortality rate). In 24 episodes of sepsis, inotropic and ventilatory support were required and 13 patients (54%) survived, Analysis of long-term survival gave estimates of 50% survival for all oncology patients admitted to the PICU and 42% for those admitted for shock. Conclusions: A high proportion of oncology patients admitted to the PICU requiring intensive intervention survive and go on to be cured of their malignancy. Our study suggests the PICU outcome for these patients has improved.