Multiprofessional Critical Care Review: Adult 2024 (MCCRCA24ON)-08_Hematoloigic

08_Hematoloigic_Oncologic Emergencies

Pdf Summary

The document provides an overview of various hematologic/oncologic emergencies, including metabolic, structural, cardiopulmonary, malignancy-related, and immunotherapy-related conditions. Tumor lysis syndrome (TLS) is discussed as a common malignancy-related emergency, characterized by the rapid lysis of tumor cells. Risk factors and grading criteria for TLS are outlined, along with strategies for its treatment such as IV fluids and rasburicase.<br /><br />Another highlighted emergency is malignant hypercalcemia, which can occur in various cancers and presents with neurologic, renal, and cardiac symptoms. Management includes volume expansion, calcitonin, and bisphosphonates. The document also touches upon other emergencies like malignant spinal cord compression, superior vena cava syndrome, and cardiac tamponade, detailing their clinical features and management.<br /><br />Furthermore, it addresses hyperviscosity syndrome, hyperleukocytosis, and leukostasis, emphasizing plasmapheresis and chemotherapy as treatment options. It also delves into immune checkpoint inhibitor toxicities, cytokine release syndrome (CRS), neurologic toxicities from CAR T-cell therapy, and hemophagocytic lymphohistiocytosis (HLH), discussing diagnostic criteria and management strategies.<br /><br />Key interventions for these emergencies mentioned in the document include IV fluids, specific medications like corticosteroids, rasburicase, and tocilizumab, as well as supportive care measures tailored to each condition. Overall, the summary outlines a comprehensive guide for the recognition and management of various hematologic/oncologic emergencies to ensure optimal patient outcomes.

Keywords

hematologic emergencies

oncologic emergencies

tumor lysis syndrome

malignant hypercalcemia

spinal cord compression

superior vena cava syndrome

cardiac tamponade

hyperviscosity syndrome

cytokine release syndrome

CAR T-cell therapy

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