Intensive care as a stage of treatment for children with cancer

Treatment of children with cancer carries a high risk of life-threatening complications. This retrospective single-center analysis evaluated all children with cancer who required admission to the pediatric intensive care unit (PICU) because of life-threatening clinical deterioration during treatment. Fifty-one children with cancer were hospitalized between 2010 and 2022 in the Department of Oncology, Hematology, and Chemotherapy of the Upper Silesian Child Health Centre, Medical University of Silesia in Katowice, and required treatment in the PICU. There were 61 hospitalizations in the PICU; 8 patients with leukemia were hospitalized twice, and 1 patient with leukemia was hospitalized three times. In the study group, most children were diagnosed with hematopoietic and lymphatic system cancers, followed by brain tumors and solid tumors. Forty-six children (75.4%) were admitted to the PICU because of septic shock, respiratory failure, and/or cardiopulmonary failure. Pharmacological support for the cardiovascular system was provided to 32 patients (52.45%), and renal replacement therapy was initiated in 11 (18.03%). Catecholamine use and renal replacement therapy significantly increased the risk of death. Life-threatening complications requiring intensive care often occur during leukemia treatment. Defining the clinical criteria for early PICU admission in children who have experienced septic shock during neutropenia can improve survival outcomes.