ABSTRACT
Subarachnoid hemorrhage (SAH) remains a serious condition with high mortality and disability. In the past decades, there have been improvements in the techniques to secure aneurysms both surgical and endovascular techniques aimed at reducing the risk of future bleeding events. Nevertheless, securing the aneurysm is only the starting point in the care of SAH patients. Intracranial and extracranial complications following SAH are common and impact long-term outcomes. Intensive care management of patients with SAH offers the opportunity to reduce morbidity by reducing secondary insults and preventing complications.
Subject(s)
Critical Care/methods , Subarachnoid Hemorrhage/therapy , Aged , Arrhythmias, Cardiac/blood , Arrhythmias, Cardiac/etiology , Arrhythmias, Cardiac/therapy , Biomarkers , Brain Damage, Chronic/etiology , Brain Damage, Chronic/prevention & control , Combined Modality Therapy , Disease Management , Embolization, Therapeutic , Female , Fever/etiology , Fever/therapy , Fluid Therapy , Humans , Hydrocephalus/etiology , Hydrocephalus/therapy , Hyperglycemia/etiology , Hyperglycemia/therapy , Intracranial Aneurysm/complications , Intracranial Aneurysm/surgery , Intracranial Aneurysm/therapy , Intracranial Hypertension/etiology , Intracranial Hypertension/prevention & control , Intracranial Hypertension/therapy , Male , Middle Aged , Pulmonary Edema/etiology , Pulmonary Edema/therapy , Recurrence , Rupture, Spontaneous , Subarachnoid Hemorrhage/complications , Subarachnoid Hemorrhage/mortality , Vasospasm, Intracranial/drug therapy , Vasospasm, Intracranial/etiology , Ventricular Dysfunction, Left/blood , Ventricular Dysfunction, Left/etiology , Ventricular Dysfunction, Left/physiopathology , Ventricular Dysfunction, Left/therapyABSTRACT
AIM: The outcomes of patients affected by hematologic malignancies (HM) admitted to Intensive Care Units (ICUs) because of life-threatening complications are still considered to be poor. The aim of this study was to assess the incidence and impact of cardiac dysfunction on the outcome of these patients. METHODS: We retrospectively reviewed the records of the 48 patients (both adult and pediatric) with HM admitted in our ICU over the last four years, collecting data on admission diagnosis, type of HM, laboratory values and organ failure. RESULTS: All patients were admitted with respiratory failure. The overall mortality rate was 50% and the mortality rates were similar among patients with different types of HM. Septic shock and multiple organ failure were the leading causes of death. The overall incidence of cardiac dysfunction was high (31%). Interestingly, the ICU mortality of this subgroup was 27%, while the mortality of the rest of the population was 61% (p<0.05). CONCLUSIONS: ICU patients with HM have high mortality. Respiratory failure caused by cardiac dysfunction seems to be associated with a lower risk of death.
