Septic shock in the immunocompromised cancer patient
| Main Author: | |
|---|---|
| Publication Date: | 2024 |
| Other Authors: | , , , , , , , , , , , |
| Format: | Other |
| Language: | eng |
| Source: | Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) |
| Download full: | http://hdl.handle.net/10362/172709 |
Summary: | Funding Information: This work was supported by a discretionary fund from the Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA. Publisher Copyright: © The Author(s) 2024. |
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Septic shock in the immunocompromised cancer patienta narrative reviewCritical careCritical care outcomesHematologic neoplasmsHematopoietic stem cell transplantationImmunocompromised hostNeoplasmsOrgan transplantationSeptic shockCritical Care and Intensive Care MedicineSDG 3 - Good Health and Well-beingFunding Information: This work was supported by a discretionary fund from the Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA. Publisher Copyright: © The Author(s) 2024.Immunosuppressed patients, particularly those with cancer, represent a momentous and increasing portion of the population, especially as cancer incidence rises with population growth and aging. These patients are at a heightened risk of developing severe infections, including sepsis and septic shock, due to multiple immunologic defects such as neutropenia, lymphopenia, and T and B-cell impairment. The diverse and complex nature of these immunologic profiles, compounded by the concomitant use of immunosuppressive therapies (e.g., corticosteroids, cytotoxic drugs, and immunotherapy), superimposed by the breakage of natural protective barriers (e.g., mucosal damage, chronic indwelling catheters, and alterations of anatomical structures), increases the risk of various infections. These and other conditions that mimic sepsis pose substantial diagnostic and therapeutic challenges. Factors that elevate the risk of progression to septic shock in these patients include advanced age, pre-existing comorbidities, frailty, type of cancer, the severity of immunosuppression, hypoalbuminemia, hypophosphatemia, Gram-negative bacteremia, and type and timing of responses to initial treatment. The management of vulnerable cancer patients with sepsis or septic shock varies due to biased clinical practices that may result in delayed access to intensive care and worse outcomes. While septic shock is typically associated with poor outcomes in patients with malignancies, survival has significantly improved over time. Therefore, understanding and addressing the unique needs of cancer patients through a new paradigm, which includes the integration of innovative technologies into our healthcare system (e.g., wireless technologies, medical informatics, precision medicine), targeted management strategies, and robust clinical practices, including early identification and diagnosis, coupled with prompt admission to high-level care facilities that promote a multidisciplinary approach, is crucial for improving their prognosis and overall survival rates. Graphical abstract: (Figure presented.)NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNNates, Joseph L.Pène, FrédéricDarmon, MichaelMokart, DjamelCastro, PedroDavid, SaschaPovoa, PedroRussell, LeneNielsen, Nathan D.Gorecki, Gabriel PetreGradel, Kim O.Azoulay, ElieBauer, Philippe R.2024-09-30T22:29:23Z2024-122024-12-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/otherapplication/pdfhttp://hdl.handle.net/10362/172709eng1364-8535PURE: 99606682https://doi.org/10.1186/s13054-024-05073-0info:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2025-05-26T01:41:34Zoai:run.unl.pt:10362/172709Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-28T18:55:18.234756Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse |
| dc.title.none.fl_str_mv |
Septic shock in the immunocompromised cancer patient a narrative review |
| title |
Septic shock in the immunocompromised cancer patient |
| spellingShingle |
Septic shock in the immunocompromised cancer patient Nates, Joseph L. Critical care Critical care outcomes Hematologic neoplasms Hematopoietic stem cell transplantation Immunocompromised host Neoplasms Organ transplantation Septic shock Critical Care and Intensive Care Medicine SDG 3 - Good Health and Well-being |
| title_short |
Septic shock in the immunocompromised cancer patient |
| title_full |
Septic shock in the immunocompromised cancer patient |
| title_fullStr |
Septic shock in the immunocompromised cancer patient |
| title_full_unstemmed |
Septic shock in the immunocompromised cancer patient |
| title_sort |
Septic shock in the immunocompromised cancer patient |
| author |
Nates, Joseph L. |
| author_facet |
Nates, Joseph L. Pène, Frédéric Darmon, Michael Mokart, Djamel Castro, Pedro David, Sascha Povoa, Pedro Russell, Lene Nielsen, Nathan D. Gorecki, Gabriel Petre Gradel, Kim O. Azoulay, Elie Bauer, Philippe R. |
| author_role |
author |
| author2 |
Pène, Frédéric Darmon, Michael Mokart, Djamel Castro, Pedro David, Sascha Povoa, Pedro Russell, Lene Nielsen, Nathan D. Gorecki, Gabriel Petre Gradel, Kim O. Azoulay, Elie Bauer, Philippe R. |
| author2_role |
author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) RUN |
| dc.contributor.author.fl_str_mv |
Nates, Joseph L. Pène, Frédéric Darmon, Michael Mokart, Djamel Castro, Pedro David, Sascha Povoa, Pedro Russell, Lene Nielsen, Nathan D. Gorecki, Gabriel Petre Gradel, Kim O. Azoulay, Elie Bauer, Philippe R. |
| dc.subject.por.fl_str_mv |
Critical care Critical care outcomes Hematologic neoplasms Hematopoietic stem cell transplantation Immunocompromised host Neoplasms Organ transplantation Septic shock Critical Care and Intensive Care Medicine SDG 3 - Good Health and Well-being |
| topic |
Critical care Critical care outcomes Hematologic neoplasms Hematopoietic stem cell transplantation Immunocompromised host Neoplasms Organ transplantation Septic shock Critical Care and Intensive Care Medicine SDG 3 - Good Health and Well-being |
| description |
Funding Information: This work was supported by a discretionary fund from the Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA. Publisher Copyright: © The Author(s) 2024. |
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2024 |
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2024-09-30T22:29:23Z 2024-12 2024-12-01T00:00:00Z |
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info:eu-repo/semantics/publishedVersion |
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http://hdl.handle.net/10362/172709 |
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eng |
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1364-8535 PURE: 99606682 https://doi.org/10.1186/s13054-024-05073-0 |
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