Hledání hranice naděje - pacient s transplantací kostní dřeně v resuscitační péči

Anest. intenziv. Med. 2002;13(3):121-123

Intensive Care in Bone Marrow Transplanted PatientsArticles

M. Kolár¹, M. Balík¹, M. Marková², E. Zikešová³: ¹ Anesteziologicko-resuscitacní klinika FN Královské Vinohrady, Praha, prednosta doc. MUDr. Jan Pachl, CSc.; ² Ústav hematologie a krevní transfuze, Praha, prozatímní vedoucí prof. MUDr. J. Klenner, DrSc.; ³ Hematologické oddelení FN Královské Vinohrady, Prah

This study followed another trial which had the relation to the patients without bone marrow transplantation who were admitted to the intensivecare unit due to critical complications. The patients in this study came from the same departments as in the previous study - the Department ofHaematology of University Hospital Královské Vinohrady and the Institute of Haematology and Blood Transfusion. The patients were admitted to theintensive care unit in the Department of Anaesthesiology and Intensive Care of University Hospital Královské Vinohrady between January 1999 andDecember 2000. 15 patients were enrolled in the study (6 patients after autotransplantation and 9 patients after allotransplantation). The authorsperformed an open and retrospective analysis. The aim of the study was determination of prognostic factors in patients with critical complications. Theresults are presented in primary formdue to the small number of patients. In patients after autotransplantation the same prognostic factors as in patientswithout bone marrow transplantation in the previous study were probably involved (the important factors were duration of leucopenia and the extentof multiorgan failure - MOF). The long-term survival rate was 50 %. The survival rate in patients after allotransplantation with critical complicationswas significantly lower (1 of 9 patients). In this group of patients favourable factors were short interval between critical complication and transplantationand absence of other adverse factors (long lasting leucopenia, MOF syndrome). In patients with adverse prognostic factors the indication of intensivecare should be careful and individual and should be made in the cooperation of haematologist (oncologist) and intensivist.