Emergencies in Hematology and Oncology

2012 ◽  
Author(s):  
Thorvardur R. Halfdanarson ◽  
William J Hogan ◽  
Timothy J Moynihan
Keyword(s):  
Spinal Cord ◽  
Pericardial Effusion ◽  
Superior Vena Cava Syndrome ◽  
Superior Vena ◽  
Tumor Lysis Syndrome ◽  
Vena Cava ◽  
Cord Compression ◽  
Tumor Lysis ◽  
Malignant Pericardial Effusion ◽  
Vena Cava Syndrome

With the rising incidence of malignancies and expanding treatment options, clinicians must learn to recognize and treat emergencies associated with them. Oncologic emergencies can be broadly classified according to organ systems, which can facilitate recognition and management. Pathophysiology, presentation, diagnosis, and treatment are discussed for complications categorized by metabolic emergencies (hypercalcemia of malignancy, tumor lysis syndrome, lactic acidosis), neurologic emergencies (malignant spinal cord compression, brain metastases, and increased intracranial pressure), cardiovascular emergencies (malignant pericardial effusion and tamponade, superior vena cava syndrome), hematologic emergencies (hyperviscosity due to monoclonal proteins, hyperleukocytosis and leukostasis), infectious emergencies (neutropenic fever, neutropenic enterocolitis, fever associated with splenectomy or functional asplenia), and pulmonary emergencies (acute airway obstruction, acute airway hemorrhage). Figures illustrate spinal cord compression, brain metastases, electrical alternans, malignant pericardial effusion, superior vena cava syndrome, hyperleukocytosis, and an algorithm for initial management of fever and neutropenia. Tables cover management of hypercalcemia of malignancy; the Cairo-Bishop definition of laboratory and clinical tumor lysis; grading, risk stratification, and management of tumor lysis syndrome; management of intracranial hypertension and seizures; infection in patients with neutropenic fever; the Multinational Association for Supportive Care in Cancer Risk Index; and indications for the addition of a gram-positive antibiotic to the initial empirical regimen. This chapter contains 181 references.

Emergencies in Hematology and Oncology

2015 ◽  
Author(s):  
David P Curley
Keyword(s):  
Spinal Cord ◽  
Magnetic Resonance ◽  
Magnetic Resonance Image ◽  
Superior Vena ◽  
Risk Index ◽  
Tumor Lysis Syndrome ◽  
Vena Cava ◽  
Severe Infection ◽  
Cord Compression ◽  
Tumor Lysis

Clinicians must be able to recognize and treat emergencies associated with malignancies and cancer treatment. Such emergencies include metabolic, neurologic, cardiovascular, hematologic, and infectious emergencies. This review details the pathophysiology, stabilization and assessment, diagnosis and treatment and disposition and outcomes for these emergencies in hematology and oncology. Figures show mechanisms of spinal cord compression, a magnetic resonance image showing a metastasis to the thoracic spine compressing the spinal cord, a contrast-enhanced magnetic resonance image of a 54-year-old female with metastatic ovarian cancer, an electrocardiogram and a cardiac echocardiogram of a 50-year-old female with malignant pericardial effusion with cardiac tamponade, a computed tomography scan of a mass compressing the superior vena cava, a blood smear from a patient with acute myeloid leukemia, and an algorithm showing the initial management of fever and neutropenia. Tables list the management of hypercalcemia of malignancy; Cairo-Bishop definition of laboratory and clinical tumor lysis; grading, risk stratification, and management of tumor lysis syndrome; management of intracranial hypertension and seizures in adults; factors favoring low risk of severe infection in patients with neutropenic fever; Multinational Association for Supportive Care in Cancer (MASCC) risk index score; and indications for the addition of a gram-positive antibiotic to the initial empirical regimen. This review contains 8 highly rendered figures, 9 tables, and 136 references.

Palliative Emergencies

2017 ◽  
Author(s):  
Marcia J. Buckley ◽  
Ann Syrett
Keyword(s):  
Spinal Cord ◽  
Palliative Care ◽  
Superior Vena Cava Syndrome ◽  
Superior Vena ◽  
Vena Cava ◽  
Cord Compression ◽  
Holistic Care ◽  
Advanced Practice ◽  
Vena Cava Syndrome ◽  
Nonpharmacological Treatments

This chapter highlights four emergencies that occur in palliative care: hemorrhage, spinal cord compression, seizures, and superior vena cava syndrome. It is imperative to understand their etiology, pathophysiology, workup, and management in order to rapidly and expertly respond to these emergencies. Palliative advanced practice registered nurses possess a unique skill set combining holistic care of patients with the ability to manage acute, often potentially devastating symptoms that affect the patient’s goals and wishes. Disease state needs to be considered when making treatment and management decisions during these palliative emergencies. The chapter presents an overview of pharmacological and nonpharmacological treatments to prevent and manage these palliative emergencies.

scholarly journals An Unusual Cause of Superior Vena Cava Syndrome: Loculated Malignant Pericardial Effusion

2016 ◽  
Vol 11 (5) ◽  
pp. 774-775
Author(s):  
Chi-Cheng Huang ◽  
Hung-Lung Hsu ◽  
Chung-Jen Teng ◽  
Shin-Rong Ke
Keyword(s):  
Pericardial Effusion ◽  
Superior Vena Cava ◽  
Superior Vena Cava Syndrome ◽  
Superior Vena ◽  
Vena Cava ◽  
Malignant Pericardial Effusion ◽  
Vena Cava Syndrome

Oncologic Emergencies (DRAFT)

2018 ◽  
Author(s):  
Harry S. Rafkin
Keyword(s):  
Superior Vena ◽  
Tumor Lysis Syndrome ◽  
Vena Cava ◽  
Cord Compression ◽  
Initial Assessment ◽  
High Morbidity ◽  
Patients With Cancer ◽  
Oncologic Emergencies ◽  
Life Threatening ◽  
Vena Cava Syndrome

Oncologic emergencies are potentially life-threatening syndromes that occur in patients with cancer, and are either directly or indirectly related to the patient’s tumor. The clinical progression of these syndromes is rapid and the initial assessment of the patient must be done quickly, as without immediate therapy, high morbidity and mortality results. The oncologic emergency may be due to the tumor, the treatment given to control the tumor, or it may be due to a previously existing condition. This chapter reviews the clinical presentation, treatment, and management of tumor lysis syndrome, hypercalcemia, hyponatremia, disseminated intravascular coagulation, hyperviscosity syndrome, spinal cord compression, and superior vena cava syndrome.

Palliative Care Emergencies in Humanitarian Crises

2019 ◽  
pp. 83-88
Author(s):  
David M. Williscroft
Keyword(s):  
Spinal Cord ◽  
Palliative Care ◽  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Cord Compression ◽  
Humanitarian Crisis ◽  
Humanitarian Crises ◽  
Medical Emergencies ◽  
Vena Cava Syndrome

Addressing medical emergencies that may arise during a humanitarian crisis is usually the greatest priority. What becomes more difficult is when patients with a palliative diagnosis or trajectory present with urgent needs and how to prioritize this unique population. Discomfort and lack of training in the area of palliative care may contribute to a lack of timely care for these patients. In this chapter, medical emergencies pertaining to patients with these discrete palliative issues are discussed. Bleeding, seizures, dyspnea, superior vena cava syndrome, and malignant spinal cord compression are reviewed, with a focus on patients who have a life-limiting diagnosis.

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