Oncologic Critical Care

Preface
	The Growing Need for Organized Oncologic Critical Care Services
Introduction
	Oncologic Critical Care: The Birth of a New Subspecialty
Acknowledgments
Contents
About the Editors
Section Editors
Contributors
Part I: Organization and Management of an Oncologic Critical Care Unit
	1 Oncologic Critical Care Department Organization
		Introduction
		The ICU Best Practice Committee
			ICU Clinical Operations Committee
			Quality and Safety Committee
			Staff Education Committee
			ICU Clinical Practice/Effectiveness and Evidence-Based Healthcare Committee
			Clinical Informatics Committee
			ICU Staff Wellness Committee
			Patient/Family and Caregiver Engagement Committee
			Research and Publications Committee: Critical Care
		Conclusion
		References
	2 ICU Utilization
		Introduction
		ICU Beds and Utilization
		ICU and Hospital Mortality
		Costs
		Specialty ICUs
		Best Practices in ICU Optimization
		Critical Care Organizations
		Conclusion
		References
	3 Critical Care Admissions and Discharge Criteria in Cancer Patients
		Introduction
			What Has Changed to Improve the Prognosis of Cancer Patients in ICUs?
			Better Results, but at What Cost?
			Organizational Aspects of the ICUs
				Oncologic vs General ICUs: Volume of Cases
				Multidisciplinary Care
				Early Warning and Admissions
				Admission Policies
		Admission Criteria
			The Patient and Their Characteristics
			Tumor Type and Stage
			Reason for Admission
			New Strategies of ICU Admission
		ICU Discharge
		Summary
		References
	4 ICU Staffing, Models, and Outcomes
		Introduction
		Open Versus Closed ICUs
		Leapfrog Group Standards
		Staffing Models
		Associated Costs in Various Models
		Associated Outcomes with 24-Hour In-house Intensivists
		Patient Ratios
		Burnout Syndrome in Intensivists
		Summary
		References
	5 Multidisciplinary Care of Critically Ill Cancer Patients
		Introduction
		Nursing
			Reasons for ICU Admission
			Complications of the Oncologic Critical Care Patient
			Compassion Fatigue
		Nutrition
			Nutrition Screening and Assessment
			Malnutrition Interventions
			Feeding Tube Placement in the Setting of Thrombocytopenia
		Physical and Occupational Therapy
			Early Mobility in the ICU
		Patient Support in the Oncologic ICU
			Patient Support
			Routine ICU Care
		Social Work and Patient Advocacy
			Role of the Social Worker in the Intensive Care Unit
			Social Worker Training
			Activities and Barriers
			Role of the Patient Advocate in the Intensive Care Unit
			Patient Advocate Training
		Chaplaincy
			History of the Chaplain
			Professional Training
			Role of the Chaplain
			Assessment Tools
			Outcomes and Efficacy of Chaplaincy
		Conclusion
		References
	6 Advanced Practice Providers in the Oncologic Intensive Care Unit
		Introduction
		Evolution of APP Role in the ICU
		APP Role in the Oncological ICU
		Outcomes of APP Role in ICU
		Advanced Practice Nursing and Professional Regulatory Requirements
			Credentialing
			Privileging
			Competency
				Professional Processes and Evaluation of APP Practice
		Implications to Clinical Practice
		Conclusion
		References
	7 Early Warning Systems and Oncological Critical Care Units
		Introduction
		Principles of Early Warning Systems
		Evolution of Early Warning Systems
		Evidence for Early Warning Systems
			Predictive Value
			Weighted Vital Sign Prediction
			Outcomes
		Human Factors and Infrastructure
			Familiarity
			Hierarchy and Division of Labor
			Infrastructure
		Early Warning Systems in an Oncology Population
		Immunotherapy
		Chemotherapy
		Conclusion
		References
	8 Rapid Response Team (RRT) in Critical Care
		Introduction
		Evolution of Rapid Response Teams (RRTs)
		Rapid Response Team and Its Components
			Implementation of Rapid Response Team
			Subset of Rapid Response Team
				Pulmonary Embolism Team
				Sepsis Response
		Oncologic Considerations
		Implications to Clinical Practice
		Conclusion
		References
	9 Quality Assurance and Improvement in the Intensive Care Unit
		Introduction
		Methods/Models to Improve Care
			Use of Evidence-Based Practice
			The Plan, Do, Study, Act (PDSA) Conceptual Framework
			Additional Quality Improvement Models
			Use of Safety Reporting
				Medication Errors
		Agencies to Evaluate Quality and Safety
			General Programs
			Oncology Programs
			ICU Specific Programs
		Identifying ICU Performance Metrics
		Conducting Quality Improvement
		Summary
		References
	10 Patient Risk Prediction Model
		Introduction
		Unique Characteristics of Cancer Patients
		Outcome Prognosticators
		System-Specific Factors
			Critical Care Improvements
			Case Volume Mix and Admission Policies
			Multidisciplinary Approach
		Patient-Specific Factors
			Age
			Performance Status
		Cancer-Specific Factors
			Neoplastic Disease and Treatment
			Acute Respiratory Failure and Mechanical Ventilation
			Organ Failure
			Neutropenia
			Solid Organ Versus Hematological Malignancy
			Repeated Critical Care Admissions
			The ICU Trial
		Outcome Prediction Models
			Outcomes Following Elective Cancer Surgery
			Long-Term Quality of Life and Morbidity
		Conclusions
		References
	11 Outcomes in Critically Ill Oncologic Patients
		Introduction
		Outcomes of Critically Ill Patients with Solid Tumors
		Outcome of Critically Ill Patients with Hematological Malignancies
		Admission of Patients with Cancer to the Intensive Care Unit
		Early ICU Admission
		Impact of Chemotherapy in Critically Ill Patients with HMs
		Conclusion
		References
Part II: Pharmacologic Considerations for the ICU Cancer Patient
	12 Role of the Clinical Pharmacist in the Oncologic Intensive Care Unit
		Introduction
		Roles and Responsibilities of the Critical Care Clinical Pharmacist
		Impact of Clinical Pharmacy Services in the ICU
		Considerations in Critically Ill Oncology Patients
		Conclusion
		References
	13 Stress Ulcer Prophylaxis in the Critically Ill Oncology Population
		Introduction
		Incidence of Clinically Important Bleeding
		Risk Factors for Clinically Important Bleeding
			Clinical Considerations in the Critically Ill Oncology Population
				Prolonged/Severe Thrombocytopenia
				Corticosteroid Use
				Chemotherapy or Radiation-Induced Upper GI Mucosal Injury
		Pharmacological Management
			PPIs Versus H2RAs: Efficacy
			PPIs Versus H2RAs: Safety
				Clostridium difficile Infection (CDI)
				Pneumonia
				Thrombocytopenia
		Clinical Controversies with SUP
			Acid Suppressive Therapy Versus Placebo in Patients Receiving Early Enteral Nutrition
		Current Guideline Recommendations
		Conclusion
		References
	14 Antimicrobial Prophylaxis in High-Risk Oncology Patients
		Introduction
		Antimicrobial Prophylaxis in Surgery
		Antimicrobial Prophylaxis Considerations in the Oncologic Critically Ill Patient
		Conclusion
		References
	15 Considerations for Medications Commonly Utilized in the Oncology Population in the Intensive Care Unit
		Introduction
		Antimicrobial Agents
			Gram Positive Agents
			Gram Negative Agents
			Antiviral Agents
			Antifungal Agents
			Pneumocystis Jiroveci Pneumonia
		Antiepileptics
		Immunosuppressants
		Antifibrinolytic/Antihemophilic Agents
			Diffuse Alveolar Hemorrhage (DAH)
			Thrombocytopenia
			Disseminated Intravascular Coagulation (DIC)
			Gastrointestinal (GI) Bleeding
		Thrombolytics
		Uric Acid Reducing Agents
		Hypercalcemia of Malignancy/Hypercalcemia Management
		Interleukin-6 Receptor Antagonists
		Growth Factors
		Antidotes
		References
	16 Complications and Toxicities Associated with Cancer Therapies in the Intensive Care Unit
		Introduction
		Toxicities of Anticancer Therapy
		References
	17 Supportive Care Considerations and Nutrition Support for Critically Ill Cancer Patients
		Introduction
		Nutrition Assessment
		Refeeding Syndrome
		Routes of Access
		Enteral Nutrition
			Common Indications
			Enteral Formula Selection Considerations
			Enteral Nutrition Protocols
			Monitoring Enteral Nutrition
			Complications of EN
				Nausea/Vomiting
				Constipation
				Diarrhea
				Bowel Ischemia
				Aspiration
				Hyperglycemia
				Overfeeding
		Parenteral Nutrition and Supplemental Parenteral Nutrition
			Complications of PN
				Hyperglycemia
				Parenteral Nutrition-Associated Liver Disease
				Hypertriglyceridemia
				Central Line-Associated Bloodstream Infection
			Special Populations
				Renal Dysfunction
				Hepatic Dysfunction
				Stem Cell Transplantation
				Obesity
		Conclusion
		References
Part III: Dermatologic Complications
	18 Graft Versus Host Disease (GHVD) in Critically Ill Oncologic Patients
		Introduction
		Etiology and Pathophysiology
		GVHD Clinical Features and Impact on Intensive Care
			Acute GVHD
			Chronic GVHD
		GVHD Prevention/Treatment and Their Impact on Intensive Care
			GVHD Prevention
			GVHD Treatment
			Immunosuppression Due to GVHD Treatment
		Prognosis
		References
	19 Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN)
		Introduction
		Etiology
			Medications
			Infections
			Malignancies
			Other Causes
		Epidemiology
			Genetics
		Pathophysiology
		Clinical Features
			Mucocutaneous Manifestations
			Ophthalmologic Manifestations
			Bronchial Manifestations
			GI Manifestations
			Renal Manifestations
			Hematologic Manifestations
			Endocrine Manifestations
			Other Manifestations and Laboratory Markers
			Histopathology
		Diagnosis
		Management
			Nonpharmacologic Management/Supportive Care
			Pharmacologic Management
				Steroids
				Cyclosporine
				IVIg
				Plasmapheresis
				Thalidomide
			Prevention
		Prognosis
		References
	20 Mycosis Fungoides in Critically Ill Cancer Patients
		Introduction
		Epidemiology
		Pathophysiology
		Clinical Features
		Diagnosis
		Staging
		Clinical Stages
		Management Algorithm
		Nonpharmacologic Treatment
			Phototherapy (UVB or PUVA)
			Local Radiation
			Extracorporeal Photopheresis
		Pharmacologic Treatment
			Topical Corticosteroids
			Topical Chemotherapy
			Topical Retinoid
			Imiquimod
			Methotrexate
			Systemic Chemotherapy
			Systemic Retinoids
			Interferon
			Histone Deacetylase Inhibitors
			Brentuximab Vedotin
			Denileukin Diftitox
		Infections
		Prognosis
		Conclusion
		References
Part IV: Neurologic Diseases
	21 Delirium and Psychosis in Critically Ill Cancer Patients
		Introduction
		Definition
		Diagnosis
		Epidemiology
			Prevalence
			Risk Factors
		Pathophysiology
			Neuroinflammation
			Neurotransmitters
			Structural Changes
			Neurological Aging
		Prevention
			Pain Management
			Sedation Management
			Early Mobilization
			Improving Sleep
			Multicomponent Intervention
			Pharmacologic Prophylaxis
		Treatment
		Conclusion
		References
	22 Medication-Induced Neurotoxicity in Critically Ill Cancer Patients
		Chemotherapy-Induced Neurotoxicity
			Introduction
			Vinca Alkaloids
			Taxanes
			Platinum Analogues
			Antimetabolites
			Other Antimetabolites
			Other
			Management
			Future Directions
		Opiates-Induced Neurotoxicity
			Introduction
			Etiology
			Epidemiology
			Pathophysiology
			Clinical Manifestations and Management
			Sedation and Drowsiness
			Delirium and Cognitive Impairment
			Myoclonus
			Opioid-Induced Hyperalgesia (OIH)
			Future Directives
		Antiepileptic Drugs-Induced Neurotoxicity
			Introduction
			Epidemiology
			Pathophysiology
			Clinical Manifestations
			Management of AED Neurotoxicity
			Future Directives
		Immunosuppressants Neurotoxicity
			Introduction
			Epidemiology
			Pathophysiology
			Clinical Manifestations
			Neuroimaging
			Management
			Future Directions
		References
	23 Seizures and Status Epilepticus in Critically Ill Cancer Patients
		Introduction
		Epidemiology
		Etiology
			Brain Tumors
			Systemic Malignancy
				Intracranial Metastasis
				Chemotherapy-Induced Seizures
				Cranial Irradiation
				Paraneoplastic Syndromes
				Other Causes
		Pathophysiology
		Clinical Features
		Diagnosis
		Management
			Pharmacologic
				Management of SE
				Pharmacologic Management of Underlying Etiology of Seizures and SE
				Long-Term Therapy for Prevention of Seizures in Oncologic Patients
		Prognosis
		Summary
		References
	24 Posterior Reversible Encephalopathy Syndrome (PRES) in Cancer Patients
		Introduction
		Etiology
		Epidemiology
		Pathophysiology
		Clinical Features
		Diagnosis
			Imaging
			Cerebrospinal Fluid Examination
			Laboratory Work
			Electroencephalogram
		Management
			Pharmacologic Management
			Nonpharmacologic Management
				Blood Pressure Control
				Seizures
				Electrolytes
				Cerebral Edema
				Thrombocytopenia
				Cerebral Hemorrhage
		Prognosis
		Conclusion
		References
	25 Stroke in Critically Ill Cancer Patients
		Introduction
		Epidemiology
		Etiology
		Pathophysiology
		Clinical Features
		Diagnosis
		Management
			Pharmacologic
		Non-pharmacologic
		Prognosis
		Conclusion
		References
	26 Intracranial Hemorrhage Focused on Cancer and Hemato-oncologic Patients
		Introduction
		Etiology
		Epidemiology
		Pathophysiology
		Clinical Features
		Diagnosis
		Management
			Pharmacologic
			Non-pharmacologic
			Management Algorithm
		Prognosis
		Conclusion
		References
	27 Increased Intracranial Pressure in Critically Ill Cancer Patients
		Introduction
			Monroe and Kellie Doctrine
		Etiologies of Increased ICP [35]
		Effect of Increased ICP
		Intracranial Pressure Monitoring
		Assessment of Intracranial Compliance and Elastance
		Pressure Autoregulation (Fig. 3)
		ICP and Outcome
		Management of Increased ICP
			Specific Therapy
				First-Tier Therapies
				Second-Tier Therapies: Osmotherapy
				Third-Tier Therapy
				ICP and Malignancy
				Role of Surgery: Last Resort Therapy
		Supportive Care
		Role of Multimodality Monitoring
		Upcoming Therapies
		Conclusion
		References
	28 Leptomeningeal Disease in Solid Cancers
		Introduction
		Etiology
		Epidemiology
		Pathophysiology
		Clinical Features
		Diagnosis
			Neuroimaging
			CSF Studies
			Neurological Assessment
		Differential Diagnosis
		Management
		Pharmacological Treatments
		Systemic Therapies
			Breast Cancer
			Non-Small Cell Lung Cancer
			Melanoma
			Intrathecal Chemotherapy
		Non-pharmacological Treatments
			Radiation
			Surgery
		Supportive Care
		Prognosis
		Future Directions
		Conclusion
		References
	29 Metastatic Spinal Cord Compression
		Introduction
		Epidemiology
		Pathophysiology
		Clinical Presentation
		Diagnosis
			History and Physical Examination
			Imaging
			Tissue Diagnosis
		Management Options
			Initial Care
			Assessment of Spinal Stability
			Pharmacological Treatments
			Radiation Therapy
			Surgical Management
			Prognosis
		References
	30 Frequent Central Nervous System (CNS) Infections in the Immunosuppressed Patient
		Introduction
		Epidemiology
		Classification
		Clinical Presentation
		Diagnosis
		Treatment
		References
Part V: Respiratory Diseases
	31 Acute and Chronic Respiratory Failure in Cancer Patients
		Introduction
		Epidemiology
		Pathophysiology
		Clinical Features
		Etiology
			Pulmonary Infections in the Cancer Patient
				Bacterial Pneumonia
				Viral Pneumonia
			Opportunistic Infections
				CMV Pneumonia
				Pulmonary Aspergillosis
				Pneumocystis jirovecii Pneumonia
				Nocardia
			Fungal Pneumonia
		Noninfectious Parenchymal Disorders
			ARDS and ARDS Mimics
			Radiation Injury and Fibrosis
			Drug-Induced Lung Injury
			Aspiration Pneumonitis and Pneumonia
			Transfusion-Related Acute Lung Injury and Circulatory Overload (TRALI/TACO)
			Organizing Pneumonia
			Parenchymal Disorders Common to HCT Patients
				Peri-Engraftment Respiratory Distress Syndrome (PERDS)
				Idiopathic Pneumonia Syndrome
				Diffuse Alveolar Hemorrhage (DAH)
			Vascular Disorders
				Pulmonary Embolism
				Pulmonary Leukostasis
			Cardiac Causes of Acute Respiratory Failure
				Congestive Heart Failure
				Pulmonary Veno-occlusive Disease
			Other Causes of Acute Respiratory Failure
				Pleural Effusions
		Diagnosis
			Diagnostic Studies
		Management
			Noninvasive Positive Pressure Ventilation and High-Flow Nasal Oxygenation
			Preparation for Mechanical Ventilation
			Treatment Strategies for Hypercapnic Respiratory Failure
			Ventilatory Therapies for Hypoxemic Respiratory Failure
		Prognosis
		References
	32 Noninvasive Oxygen Therapies in Oncologic Patients
		Introduction
		Spectrum of ARF in Oncologic Patients
			What Is Unique About ARF in Oncologic Versus Nononcologic Patients
				Cause of ARF
				Diagnostic Challenge
				Frailty
				Increased Mortality
				Long-Term Outcomes Trajectory
				Hematologic Malignancy Versus Solid Tumor
		Noninvasive Oxygen Modalities
			Continuous Oxygen Therapy
			Noninvasive Ventilation
			High-Flow Nasal Cannula
		Evidence of NIV
			General Population
			Immunocompromised and Oncologic Patients
				Noninvasive Ventilation in Early ARF Versus Conventional Oxygen Therapy to Prevent Intubation
				Noninvasive Ventilation in ARDS Versus Invasive Mechanical Ventilation (via Intubation)
					Theories of Harm Associated with NIV
					Is There a Role for NIV in Oncologic Patients with ARDS?
		Evidence for HFNC
			General Population
			Immunocompromised and Oncologic Population
		Conclusions
		References
	33 Respiratory Support Strategies and Nonconventional Ventilation Modes in Oncologic Critical Care
		Introduction
		Nonconventional Ventilation Modes
			Biphasic Ventilation
			High-Frequency Ventilation
			Pressure-Regulated Volume Control (PRVC)
			Neurally Adjusted Ventilatory Assist Ventilation (NAVA)
		ECMO
		Conclusion
		References
	34 Prone Ventilatory Therapy in Critically Ill Cancer Patients
		Introduction
		Etiology
		Epidemiology
		Pathophysiology
		Clinical Features
		Diagnosis
		Management
			Pharmacologic
			Non-pharmacologic
		Prognosis
		References
	35 Extracorporeal Membrane Oxygenation (ECMO) Critically Ill Cancer Patients
		Introduction
		Principles of ECMO
			Extracorporeal Gas Exchange
			Circulatory Support
		General Indications and Clinical Data
		ECMO in Cancer Patients
			Cancer Patients
			Hematopoietic Stem Cell Transplantation
			Indications for ECMO in Cancer Patients
			Contraindications for ECMO in Cancer Patients
		Special Considerations for the Management of Cancer Patients on ECMO
			Bleeding and Anticoagulation
			Ventilatory Management and Infection Control
			Chemotherapy on ECMO
			Ethical Considerations
		Summary
		References
	36 Cancer Treatment-Related Lung Injury
		Introduction
		Chemotherapy-Induced Lung Injury
			General Principals
				Incidence and Risk Factors
				Diagnosis
				Clinical Presentation
				Histopathologic Features of DILD
				Specific Clinical and Histopathologic Patterns of DILD
		Lung Injury Associated with Cancer Immunotherapies
			Immune Checkpoint Blocking Agents
			Genetically Engineered Immunotherapies
		Radiation-Induced Lung Injury
			Clinical Presentation
			Radiation Recall Pneumonitis
			Other Manifestations of Radiation-Induced Lung Injury
			Management of Radiation-Induced Lung Injury
		References
	37 Acute Respiratory Distress Syndrome in Cancer Patients
		Introduction
		Definition and Pathogenesis of ALI and ARDS
		Pathophysiology and Pathogenesis of ALI/ARDS
		Etiology and Predisposing Factors of ARDS in the Cancer Patient
		Primary and Secondary Triggers of ALI/ARDS in the Cancer Patient
			Pneumonia/Opportunistic Infections
			Drug-Induced Acute Lung Injury (ALI)/ARDS
			Postoperative ARDS
			ALI/ARDS Post Hematopoietic Stem Cell Transplant
			ALI/ARDS Due to Pulmonary Spread of Tumor: Lymphangitic Carcinomatosis and Pulmonary Leukostasis
		Clinical Presentation and Diagnostic Workup of ALI/ARDS
		Cancer-Related ALI/ARDS: Outcomes and Treatment
		Treatment
			Pharmacologic Therapies
			Noninvasive and Invasive Ventilation
			Sedation and Neuromuscular Blockade
		Conclusion
		References
	38 Diffuse Alveolar Hemorrhage in Critically Ill Cancer Patients
		Introduction
		Epidemiology
		Etiology
		Pathophysiology
		Clinical Features
		Diagnosis
		Management
		Prognosis
		Conclusion
		References
	39 Differentiation (Retinoic Acid) Syndrome in Critically Ill Cancer Patients
		Introduction
		Etiology
		Epidemiology
		Pathogenesis
		Physiopathology
		Clinical Features
			Symptoms and Signs
			Laboratory
			Imaging
		Diagnosis
		Differential Diagnosis
		Management
			Pharmacologic
			Non-pharmacologic
			Management Algorithm
		Prognosis
		Summary
		References
	40 Pneumonia in the Cancer Patient
		Introduction
		Mechanisms of Susceptibility
			Anatomical Contributions
			Innate Immune Dysfunction
			Neutrophil Defects
			Lymphocyte Dysfunction
			Other Mechanisms
			Critical Illness
		Notable Pathogens
			Bacteria
			Fungi
			Viruses
		Epidemiology
		Clinical Presentation
		Diagnostic Studies
			Imaging
			Respiratory Samples
			Non-respiratory Samples
		Management
			Prevention
			Pharmacologic Therapies
			Non-pharmacologic Therapies
		Prognosis
		Conclusion
		References
	41 Late Noninfectious Pulmonary Complications in Hematopoietic Stem Cell Transplantation
		Introduction
		Bronchiolitis Obliterans
			Clinical Features and Diagnosis
			Risk Factors and Pathogenesis
			Treatment
			Clinical Course and Prognosis
		Idiopathic Pneumonia Syndrome
			Pathogenesis and Risk Factors
			Clinical Features and Diagnosis
			Treatment
			Clinical Course and Prognosis
		Organizing Pneumonia
			Clinical Features and Diagnosis
			Risk Factors and Pathogenesis
			Treatment
			Clinical Course and Prognosis
		Pulmonary Venocclusive Disease
			Clinical Features, Pathogenesis, and Diagnosis
			Treatment and Prognosis
		Pulmonary Cytolytic Thrombi
		Pleuroparenchymal Fibroelastosis
		Thoracic Air Leak Syndrome
		Post-transplant Lymphoproliferative Disorder
		Conclusion
		References
	42 Pleural Disease: Malignant and Benign Pleural Effusions
		Introduction
		Epidemiology
		Pathophysiology
		Etiology
		Diagnosis
			Confirmation of the Effusion: Imaging Studies
			Classification as Transudates or Exudates
			Identifying the Underlying Cause
		Clinical Relevance
		Pleural Effusion Drainage
			Continuous or Repetitive Drainage
			Permanent Catheters
		Pleural Effusion in Malignant Neoplasms
		Conclusion
		References
	43 Management of Tracheobronchial Diseases in Critically Ill Cancer Patients
		Introduction
		Hemoptysis
			Etiology, Severity, and Prognosis of Hemoptysis
			Initial Evaluation of Hemoptysis
			Management of Hemoptysis
		Central Airway Obstruction
			Clinical Presentation and Evaluation of Central Airway Obstruction
			Management of Central Airway Obstruction
		Conclusion
		References
	44 Tracheostomy
		Introduction
		Epidemiology
		Indications
			Upper Airway Obstruction
			Respiratory Failure and Prolonged Mechanical Ventilation
		Expected Benefits
			Mortality
			Patient Comfort and Sedation Requirements
			Long-Term Airway Complications
			Reduce the Length of Mechanical Ventilation or ICU Stay
			Reduce the Risk of Ventilator-Associated Pneumonia
		Contraindications
		Appropriate Timing
		Appropriate Technique
		Conclusion
		References
	45 Pulmonary Hypertension in an Oncologic Intensive Care Unit
		Introduction
		Etiology
			Pulmonary Arterial Hypertension (PAH)
				Surgery in Patients with Preexisting PAH
		Epidemiology
			PAH
		Pathophysiology
			Preload
			Afterload
			Contractility and Perfusion
			Chronic PH
		Clinical Features
		Diagnosis
			Echocardiography
			Right Heart Catheterization (RHC)
		Management
			Stabilize and Identify Triggers
			Optimize Preload
			Oxygenation and Ventilation
			Reduce Right Ventricular (RV) Afterload
			Optimize RV Contractility and Perfusion
			Pharmacologic Treatment Modalities
				Nitric oxide
				Prostacyclins
				Other pulmonary vasodilators
			Nonpharmacologic Treatment Modalities
				Balloon Atrial Septostomy (BAS)
				Mechanical Circulatory Support
				Transplantation
			End-of-Life Care
		Prognosis
		Conclusion
		References
	46 Sleep Disorders in Critically Ill Cancer Patients
		Introduction
		Sleep Disturbances in the Cancer Patient
		Sleep in the ICU
			Sleep in the Critically Ill Cancer Patient
		Conclusion
		References
Part VI: Cardiovascular Diseases
	47 Acute Coronary Syndrome, Thrombocytopenia, and Antiplatelet Therapy in Critically Ill Cancer Patients
		Introduction
		Etiology and Pathophysiology
			Acute Coronary Syndromes
			Thrombocytopenia
		Epidemiology
		Clinical Features
		Diagnosis Challenges
		Management
			Pharmacologic
				Antiplatelet Therapy
				Strategies to Minimize DAPT Duration
					Risk Scores
					Platelet Function Tests
					Stent Thrombosis Risk Evaluation
					Perioperative Management of Antiplatelet Therapy
				Anticoagulation in Cancer
				Thrombolytic Therapy
			Non-pharmacologic
				Invasive Approach
				Stent Types
			Management Algorithm
		Prognosis
		References
	48 Arrhythmias in Cancer Patients
		Introduction
		Etiology
		Diagnosis
			Bradyarrhythmias
			Tachyarrhythmias
				Narrow Complex Tachycardias
				Wide Complex Tachycardias
			QT Prolongation
		Management
			Acute Management
			Management of Bradycardia
				Management of Cardiac Implantable Electronic Devices During MRI
				Management of Patients with CIEDs During Radiation Therapy
		Management of Tachycardia
		Management of QT Prolongation
		Summary
		References
	49 Hemodynamic Evaluation and Echocardiography in the Oncologic Intensive Care Unit
		Introduction
		Hemodynamics
			Stroke Volume and Cardiac Output
			Left Ventricle Systolic Function
			Right Ventricle Dimension, Systolic Function, and Pulmonary Artery Pressures
			Diastolic Ventricular Function and Estimation of Filling Pressures
			Volume Status Assessment and Prediction of Fluid Responsiveness
		Pulmonary Embolism and Pulmonary Hypertension
			Pulmonary Embolism
			Pulmonary Hypertension
		Pericardial Disease
		Shock Conditions
		Cardiac Tumors
		Transesophageal Echocardiography
			Suboptimal Transthoracic Images
			Intracardiac Thrombus
			Assessment of Valvular Pathology
			Post-cardiac Surgery Tamponade
			Aortic Dissection
		Conclusion
		References
	50 Hemodynamic Evaluation and Minimally Invasive Hemodynamic Monitoring in Critically Ill Cancer Patients
		Introduction
		Hemodynamic Evaluation
		Common Pathophysiology During Critical Illness Related to Cancer
		Hemodynamic Monitoring
			Macro-hemodynamic Monitors
				Preload Monitoring
				Cardiac Output Monitoring
					Shifting Trend in Cardiac Output Measurement
						Less Invasive Cardiac Output Monitoring
						Minimally Invasive Cardiac Output Monitoring
						Arterial Waveform Analysis
						Doppler Flow Measurement
						Noninvasive Cardiac Output Monitoring
				Echocardiography
			Microcirculation Monitor
		Application of Hemodynamic Monitoring
		Conclusion
		References
	51 Interventional Cardiology in the Cancer Patient
		Introduction
		Ischemic Heart Disease
			Coronary Artery Pressure Flow Assessment
			Acute Coronary Syndromes
		Takotsubo Cardiomyopathy
		Device-Based Therapies for Heart Failure
		Pericardial Effusions and Pericardiocentesis
		Endomyocardial Biopsy
			Chemotherapy-Induced Myocarditis and Cardiomyopathy
			Cardiac Tumors
			Infiltrative Cardiomyopathies
		Structural Valve Disease
		Peripheral Vascular Disease
			Tyrosine Kinase Inhibitor-Induced Vascular Disease
			Radiation-Induced Vascular Disease
		Radiation-Induced Heart Disease
		References
	52 Management of Pericardial Effusions/Tamponade in Cancer Patients
		Introduction
		Epidemiology
		Anatomy of the Pericardium
		Causes of Effusions
		Clinical Features
		Diagnostic Modalities
			Imaging
				Echocardiogram
				Computed Tomography (CT) Scan
				Electrocardiogram
				Laboratory Analysis and Cytology
		Management
			Cardiac Tamponade
		Technique
			Catheter Removal
			Special Circumstances
		Prognosis
		References
	53 Chemotherapy-Related Cardiovascular Complications
		Introduction
		Etiology
			Acute Coronary Syndrome
			Heart Failure
			Chemotherapy-Related Arrhythmia
			Myocarditis
			Takotsubo Cardiomyopathy
			Acute Aortic Dissection
			Hypertensive Emergency
			Pericardial Effusion
		Epidemiology
			Acute Coronary Syndrome
			Heart Failure
			Chemotherapy-Related Arrhythmia
			Myocarditis
			Takotsubo Cardiomyopathy
			Acute Aortic Dissection
			Hypertensive Emergency
			Pericardial Effusion
		Pathophysiology
			Acute Coronary Syndrome
			Heart Failure
			Chemotherapy-Related Arrhythmia
			Myocarditis
			Takotsubo Cardiomyopathy
			Acute Aortic Dissection
			Hypertensive Emergency
			Pericardial Effusion
		Clinical Features
			Acute Coronary Syndrome
			Heart Failure
			Chemotherapy-Related Arrhythmia
			Myocarditis
			Takotsubo Cardiomyopathy
			Acute Aortic Dissection
			Hypertensive Emergency
			Pericardial Effusion
		Diagnosis
			Acute Coronary Syndrome
			Heart Failure
			Chemotherapy-Related Arrhythmia
			Myocarditis
			Takotsubo Cardiomyopathy
			Acute Aortic Dissection
			Hypertensive Emergency
			Pericardial Effusion
		Management
			Acute Coronary Syndrome
			Heart Failure
			Chemotherapy-Related Arrhythmia
			Myocarditis
			Takotsubo Cardiomyopathy
			Acute Aortic Dissection
			Hypertensive Emergency
			Pericardial Effusion
		Prognosis
			Acute Coronary Syndrome
			Heart Failure
			Chemotherapy-Related Arrhythmia
			Myocarditis
			Takotsubo Cardiomyopathy
			Acute Aortic Dissection
			Hypertensive Emergency
			Pericardial Effusion
		Conclusion
		References
	54 Outcomes After Cardiopulmonary Resuscitation in the Cancer Patient
		Introduction
		Immediate Survival Post-cardiac Arrest
		Clinical Variables Pertinent to Post-Cardiac Arrest Outcomes
			Location of CPR: In-Hospital and Out-of-Hospital Cardiac Arrest
			Type of Cancer and Staging
			Age, Comorbidities, and Functional Status
			Rhythm and Characteristics of CPR
			Other Variables
		Long-Term Survival
		Discussing Advance Directives, Suitability of CPR, and Barriers
		Conclusion
		References
Part VII: Gastrointestinal Disease
	55 Acute Abdomen in Cancer Patients
		Introduction
		Malignant Bowel Obstruction
		Typhlitis/Neutropenic Enterocolitis
		Radiation Enteritis
		Gastrointestinal Perforations
		Intestinal Graft Versus Host Disease After Treatment
		Mesenteric and Bowel Ischemia
		Conclusion
		References
	56 Gastrointestinal Bleeding in Critically Ill Cancer Patients
		Introduction
		Etiology
		Epidemiology
		Pathophysiology
		Management
			Pharmacological Therapies
			Nonpharmacological Therapies
		Prognosis
		Conclusion
		References
	57 Endoscopic and Pharmacologic Management of Upper GI Bleeding
		Introduction
		Etiology
		Epidemiology
		Pathophysiology
		Clinical Features
		Diagnosis
		Management
			Resuscitation
			Transfusions
			Management of Antithrombotic Agents
		Pharmacologic Management of Nonvariceal Upper GI Bleeding
			Preendoscopic Management
			Intraendoscopic Management
			Postendoscopic Management
		Pharmacologic Management of Variceal Upper GI Bleeding
			Preendoscopic Management
			Intraendoscopic Management
			Postendoscopy Management
		Prognosis
		Management Algorithms
		Conclusion
		References
	58 Malignant Ascites in Critically Ill Cancer Patients
		Introduction
		Etiology and Epidemiology
		Pathogenesis and Physiopathology
		Clinical Features
			Diagnosis
			Definitions of IAP
			Physiopathology
		Treatment
			Technique
		Prognosis
		Conclusions
		References
	59 Hepatobiliary Diseases in the Cancer Patient Leading to Critical Illness
		Acute Liver Failure
			Introduction
			Etiology
			Pathogenesis
			Management Considerations
				Etiology Specific Management
				Organ System Specific Management
					Hepatic Encephalopathy
						Grade I-II Hepatic Encephalopathy
						Grade III-IV Hepatic Encephalopathy
				Acute Lung Injury
					Coagulopathy
					Risk of Infection and Sepsis
					Acute Kidney Injury
		Prognosis and the Role of Transplantation
			Liver Transplant in Cancer Patients with Acute Liver Failure
		Hepatic Tumor Rupture
			Introduction
			Pathogenesis
			Clinical Presentation and Diagnosis
			Management
				Transarterial Embolization
				Surgical Hemostasis
			Prognosis
		Pyogenic Liver Abscess
			Introduction
			Etiology
			Pathogenesis and Risk Factors
			Clinical Presentation and Diagnosis
			Management Considerations
				Medical Management
				Percutaneous Drainage
				Surgical Drainage
			Prognosis
		Variceal Hemorrhage in Patients with Portal Hypertension
			Introduction
			Etiology and Pathogenesis
			Diagnostic and Management Considerations
				Medical Management of Variceal Hemorrhage
				Endoscopic Management of Variceal Hemorrhage
			Prognosis of Variceal Hemorrhage
		Cholangitis and Cancer
			Introduction
			Pathogenesis
			Diagnostic and Management Considerations
				Diagnostic Imaging
				Supportive Care and Empiric Antibiotic Therapy
				Endoscopic or Percutaneous Drainage
		Acute Cholecystitis
			Introduction
			Etiology
			Pathogenesis
			Clinical Manifestations and Diagnostic Considerations
			Management Considerations
			Prognosis
		Mesenteric Venous Thrombosis
			Introduction
			Etiology
			Pathogenesis
			Clinical Presentation and Diagnostic Considerations
			Management Considerations
			Prognosis
		References
Part VIII: Renal and Genitourinary Disease
	60 Acute Renal Failure in Critically Ill Cancer Patients
		Introduction
		Definition
		Incidence and Outcome
		Evaluation
		Prevention and Treatment of Acute Kidney Injury
		Specific Circumstances
			Hematological Malignancies
			Multiple Myeloma
			Thrombotic Microangiopathy
			Hematopoietic Stem Cell Transplantation
				Graft Versus Host Disease
				Sinusoidal Obstruction Syndrome
				Thrombotic Microangiopathy
			Tumor Lysis Syndrome
			Renal Cell Cancer
			Urinary Tract Obstruction
			Hypercalcemia of Malignancy
			Drug Therapy
				Traditional Chemotherapy
				Targeted Therapies
				Immunomodulators
		Summary
		References
	61 Renal Replacement Therapy in Critically Ill Cancer Patients
		Introduction
		Initiation of Renal Replacement Therapy (Timing)
		Modalities
			Dialysis
			Hemofiltration
			Isolated Ultrafiltration
		Methods
		Intensity of Dialysis
		Anticoagulation
		Special Considerations
			Myeloma Cast Nephropathy
			Drug Clearance
		Conclusions
		References
	62 Hematuria in the Critically Ill Cancer Patients
		Introduction
		Definition
		Epidemiology
		Etiology
		Pathophysiology
		Clinical Features
		Diagnosis
		Management
		Prognosis
		Conclusion
		References
	63 Hemorrhagic Cystitis in the Critically Ill Cancer Patient
		Introduction
		Etiology
			Noninfectious Hemorrhagic Cystitis
			Infectious Hemorrhagic Cystitis
			Radiation Induced HC
		Epidemiology
		Clinical Features
		Prevention and Treatment
		Intravesical Therapy
		Systemic Therapy
		Surgical Intervention
		Prognosis
		Conclusion
		References
	64 Obstructive Uropathy in Critically Ill Cancer Patients
		Introduction
		Etiology
		Epidemiology
		Pathophysiology
		Diagnosis
		Treatment
		Prognosis
		Conclusion
		References
Part IX: Metabolic/Endocrine Complications
	65 Adrenal Emergencies in Critically Ill Cancer Patients
		Adrenal Insufficiency
			Introduction
			Etiology
				Primary Adrenal Insufficiency
				Secondary Adrenal Insufficiency
				Tertiary Adrenal Insufficiency
			Epidemiology
			Pathophysiology
			Clinical Features
			Diagnosis
				Immune-Related Adverse Events (irAEs)
				Critical Illness-Related Corticosteroid Insufficiency (CIRCI)
				Primary AI
				Secondary AI
				Tertiary AI
			Treatment
				Immune-Related Adverse Events (irAEs)
				Adrenal Crisis
				CIRCI
				Perioperative Stress-Dose Steroids
			Prognosis
		Pheochromocytoma
			Introduction
			Etiology
			Epidemiology
			Pathogenesis
			Clinical Features
			Diagnosis
			Treatment
			Prognosis
		Conclusion
		References
	66 Carcinoid Crisis in the Intensive Care Unit
		Introduction
		Clinical Features
		Etiology
		Pathophysiology
		Differential Diagnosis
		Risk Factors
		Management
		Conclusion
		References
	67 Thyroid Emergencies in Critically Ill Cancer Patients
		Introduction
		Myxedema Coma
			Etiology
			Epidemiology
			Pathophysiology
			Clinical Features
		CNS Manifestations
		Respiratory Manifestations
		Cardiac Manifestations
		Dermatologic and Gastrointestinal Manifestations
		Renal Manifestations
			Diagnosis
			Management
			Pharmacologic
			Non-pharmacologic
			Management Algorithm
			Prognosis
		Thyroid Storm
			Etiology
			Epidemiology
			Pathophysiology
			Clinical Features
			Diagnosis
			Management
				Pharmacological
				Non-pharmacological
				Management Algorithm
			Prognosis
		Non-thyroidal Illness Syndrome
		Conclusion
		References
	68 Electrolytic Abnormalities Related to Calcium in Critically Ill Cancer Patients
		Introduction
		Calcium Homeostasis
			Hypercalcemia
				Epidemiology
				Etiology
				Pathophysiology
					Humoral Hypercalcemia of Malignancy (HHM)
					Local Osteolytic Hypercalcemia
					Tumor Production of 1,25(OH)2D
					Ectopic PTH Secretion
				Clinical Features
				Diagnosis
				Management
					Fluids and Diuresis
					Bisphosphonate Therapy
					Other Agents and Hemodialysis
				Prognosis
			Hypocalcemia
				Epidemiology
				Etiology
				Pathophysiology
				Clinical Features
				Diagnosis
				Management
				Prognosis
		Conclusion
		References
	69 Electrolytic Abnormalities Related to Phosphate in Critically Ill Cancer Patients
		Introduction
		Phosphate Homeostasis
		Hyperphosphatemia
			Epidemiology
			Etiology
			Pathophysiology
			Clinical Features
			Diagnosis
			Management
			Prognosis
		Hypophosphatemia
			Epidemiology
			Etiology
			Pathophysiology
			Clinical Features
			Diagnosis
			Management
			Prognosis
		Conclusion
		References
	70 Electrolytic Abnormalities Related to Sodium in Critically Ill Cancer Patients
		Introduction
		Sodium Homeostasis
		Hypernatremia
			Epidemiology
			Etiology
			Pathophysiology
			Clinical Features
			Diagnosis
			Management
			Prognosis
		Hyponatremia
			Epidemiology
			Etiology
			Pathophysiology
			Clinical Features
			Diagnosis
			Management
			Prognosis
		Conclusion
		References
	71 Electrolytic Abnormalities Related to Potassium in Critically Ill Cancer Patients
		Introduction
		Potassium Homeostasis
			Hyperkalemia
				Epidemiology
				Etiology
				Pathophysiology
				Clinical Features
				Diagnosis
				Management
				Prognosis
			Hypokalemia
				Epidemiology
				Etiology
				Pathophysiology
				Clinical Features
				Diagnosis
				Management
				Prognosis
		Conclusion
		References
	72 Electrolytic Abnormalities Related to Magnesium in Critically Ill Cancer Patients
		Introduction
		Magnesium Homeostasis
			Hypermagnesemia
				Epidemiology
				Etiology
				Pathophysiology
				Clinical Features
				Diagnosis
				Management
				Prognosis
			Hypomagnesemia
				Epidemiology
				Etiology
				Pathophysiology
				Clinical Features
				Diagnosis
				Management
				Prognosis
		Conclusion
		References
	73 Hypoglycemia and Hyperglycemia in Critically Ill Cancer Patients
		Introduction
		Etiology
			Hyperglycemia
				Stress-Induced Hyperglycemia
					Sepsis and Infections
				Drug-Related Hyperglycemia
				Parenteral Nutrition
			Hypoglycemia
		Epidemiology
			Hyperglycemia
			Hypoglycemia
		Pathophysiology
			Hyperglycemia
			Hypoglycemia
		Clinical Features
		Diagnosis
		Management
		Prognosis
		Conclusions
		References
Part X: Hematologic Diseases
	74 Benign Hematological Diseases in Cancer Patients
		Introduction
		Anemia
			Hypoproliferative Anemia
			Anemia Due to Red Blood Cell Destruction
			Anemia from Blood Loss
			Diagnosing Anemia
			Treating Anemia
		Thrombocytopenia
			Chemotherapy-Induced Thrombocytopenia
			Non-chemotherapy-Induced Thrombocytopenia
			Immune Thrombocytopenia
			DIC
			Thrombotic Microangiopathies
			Hypersplenism
		Neutropenia
			Congenital Neutropenia
			Chemotherapy-Induced Neutropenia
			Non-chemotherapy Drug-Related Neutropenia
			Diseases Associated with Neutropenia
		Coagulopathy
			Coagulopathy in Cancer Patients
			Other Causes of Coagulopathy
			Management of Coagulopathy
		Hypercoagulability
			Mechanisms of Hypercoagulability
			Inherited Hypercoagulability
			Acquired Hypercoagulability
			Occult Cancer and Hypercoagulability
			Testing for Hypercoagulability
		Conclusion
		References
	75 Thrombotic Thrombocytopenic Purpura and Hemolytic Uremic Syndrome in Cancer Patients
		Introduction
		Etiology
			Thrombotic Thrombocytopenic Purpura
			Hemolytic Uremic Syndrome
		Epidemiology
			TTP
			HUS
			CM-HUS
		Pathophysiology
			TTP
			HUS
		Clinical Features
			TTP
			HUS
			CM-HUS
		Diagnosis
			TTP
			HUS
			CM-HUS
		Management
			TTP
			HUS
			CM-HUS
		Prognosis
			TTP
			HUS
			Complement-Mediated HUS
		Conclusion
		Cross-References
		References
	76 Tumor Lysis Syndrome in the Cancer Patient
		Introduction
		Etiology
		Diagnosis
		Epidemiology
			Pathophysiology
		Clinical Features
			Uric Acid
			Potassium
			Phosphorus and Calcium
			Acute Kidney Injury
		Risk Factors and Predictors of TLS
			Tumor-Related Factors
			Patient-Related Risk Factors
		Risk Classification
		Management
			Prevention and Treatment
			Volume Expansion and Diuretics
			Hypouricemic Agents
				Allopurinol
				Febuxostat
				Rasburicase
			Urine Alkalinization
		Electrolyte Management
			Hyperkalemia
			Hyperphosphatemia
			Hypocalcemia
			Indication for Dialysis
		Indications for Intensive Care Unit Management
		Summary
		References
	77 Blast Crisis of Chronic Myeloid Leukemia (CML)
		Introduction
		Definition
		Epidemiology
		Pathophysiology
		Diagnosis and Clinical Presentation
		Diagnostic Work-Up (Fig. 3)
		Treatment Approach (Algorithm - Fig. 4)
			Emergency and Supportive Management
			Definitive Therapy
		Conclusion
		References
	78 Hyperleukocytosis in Cancer Patients
		Introduction
		Epidemiology
		Pathophysiology
		Clinical Features and Diagnostics
		Management
		Summary
		References
	79 Hemophagocytic Lymphohistiocytosis in the Cancer Patient
		Introduction
		Etiology
		Epidemiology
		Pathophysiology of Secondary HLH
		Clinical Features
		Diagnosis
		Management
		Prognosis
		Conclusion
		References
Part XI: Transfusion Medicine
	80 Statistics in Blood Collection and Transfusion
		Introduction
		Global Collection and Transfusion of Blood
		The United States Blood Supply
		Blood Component Use and Adverse Events
		The Production of Plasma Derivatives
		Hemovigilance Programs
		Summary
		References
	81 Blood Components
		Introduction
		Collection of Blood
		Characteristics and Storage Conditions of Blood Components
			Whole Blood
			Red Blood Cells (RBCs)
			Platelets
			Plasma
			Cryoprecipitate
			Granulocytes
			Modifications of Blood Components
			Leukoreduction
			Irradiation
			Washing
		Summary
		References
	82 Transfusion Reactions
		Introduction
		Acute Transfusion Reactions
		Hemolytic Transfusion Reactions
		Febrile Non-hemolytic Transfusion Reactions
		Allergic Transfusion Reactions
		Transfusion-Related Acute Lung Injury (TRALI)
		Transfusion-Associated Circulatory Overload (TACO)
		Hypotensive Reactions to Transfusion
		Transfusion-Associated Sepsis (TAS)/Bacterial Contamination
		Thermal Effect
		Metabolic Complications
		Initial Management of a Suspected Acute Transfusion Reaction
		Delayed Transfusion Reactions
			Delayed Hemolytic Transfusion Reaction
		Transfusion-Associated Graft-Versus-Host Disease (TA-GVHD)
		Posttransfusion Purpura (PTP)
		Iron Overload
		References
	83 Transfusion-Related Acute Lung Injury (TRALI)
		Introduction
		Frequency of TRALI
		Pathogenesis of TRALI
		Mitigation Measures
		Workup and Differential Diagnosis
		Management of TRALI and Suspected TRALI
		References
	84 Alternatives to Blood Products
		Introduction
		Not Ordering Blood Products
		Declining Use of Blood Products
		Improving Blood Production
			Iron Replacement Therapy
			Folate and Vitamin B12 Supplementation
			Erythropoiesis-Stimulating Agents
		Alternatives to Prevent/Stop Bleeding
		Surgical Techniques as Transfusion Alternatives
		Synthetic Blood Products
		Summary Recommendations
		References
	85 Massive Transfusion Protocols (MTPs) in Cancer Patients
		Introduction
		Definition
			Massive Transfusion
			Massive Transfusion Protocol at The University of Texas MD Anderson Cancer Center
		Summary
		References
	86 Guidelines for Blood Transfusion in Patients
		Introduction
		RBC Transfusion
		Platelet Transfusion
		Plasma Transfusion
		Cryoprecipitate Transfusion
		Granulocyte Transfusion
		Transfusion Alternatives and Bloodless Medicine
		Bloodless Medicine
		Summary
		References
Part XII: Vascular Complications
	87 Management of Arterial Bleeding in Critically Ill Cancer Patients
		Introduction
		Etiology and Epidemiology
		Pathophysiology and Clinical Features
		Diagnosis and Management
			Carotid Artery Blowout
			Hemoptysis
			Hematuria
			Artery to Bowel Fistula
			Postoperative Pseudoaneurysms
		Prognosis
		References
	88 Prevention and Management of Venous Thromboembolism in the Cancer Patient
		Introduction
		Etiology
		Epidemiology
		Pathophysiology
		Clinical Features
		Prevention
		Diagnosis
			Compression Ultrasonography
			Computed Tomography (CT) Pulmonary Angiography
			Echocardiography
			Ventilation-Perfusion Scanning
		Management
			Risk Stratification
			Hemodynamic and Respiratory Support
			Systemic Anticoagulation
			Other Treatment Options
			Catheter-Directed Therapies
			Inferior Vena Cava Filters
		Prognosis
		References
	89 Superior Vena Cava Syndrome in Critically Ill Cancer Patients
		Introduction
		Etiology
			Etiology: Less Common Causes
		Epidemiology
		Pathophysiology
			Anatomy and Physiology
		Management Guidelines and Algorithms: [8]
		Clinical Characteristics
			Clinical Presentation
		Diagnosis
			Imaging Diagnosis
		Treatment
			Other Treatment Modalities
			Anticoagulation
			Treatment Complications
		Prognosis
		Conclusions
		Future Directions
		References
	90 Catheter-Related Deep Vein Thrombosis in Critically Ill Cancer Patients
		Introduction
		Catheter-Specific Risk Factors
			Catheter Location
			Catheter Type
			Catheter Placement Technique
		Clinical Implications of Thrombosis
		Prevention/Prophylaxis
		Treatment
		Summary
		References
Part XIII: Infectious Diseases
	91 Infection Prevention in Critical Care Settings
		General Aspects of Hospital-Acquired Infections
		Aim and Structure of an Infection Prevention Program
		General Aspects of Infection Prevention
			Hand Hygiene
			Isolation Precautions and Communicable Diseases
			Sterile Techniques
		Specific Infection Prevention Measures Against Nosocomial Infections
			Bundles for Device-Related Infections
			Screening Techniques
		Monitoring Outcomes and Performance Evaluation
		Special Considerations in the Critically Ill Oncologic Patient
		References
	92 Antimicrobial Stewardship in Critically Ill Cancer Patients
		Introduction
		Antimicrobial Usage in Cancer Patients
		Goals of Antimicrobial Stewardship in Cancer Patients
		The Antimicrobial Stewardship Team
		Specific Antimicrobial Stewardship Strategies
		Formulary Restriction and Preauthorization
		Prospective Audit with Intervention and Feedback
		Formulary Management
		Antimicrobial Prophylaxis
		Antimicrobial Cycling and/or Heterogeneity
		Education
		Institutional Guidelines and Pathways
		De-escalation of Therapy
		Transition from Parenteral to Oral Therapy
		Role of the Microbiology Laboratory
		Monitoring and Measuring Outcomes
		Summary and Future Directions
		References
	93 Neutropenic Fever in the Intensive Care Unit
		Introduction
		Etiology
		Epidemiology
			Neutropenic Fever
			Neutropenic Sepsis
		Pathophysiology
		Clinical Features
		Diagnosis
		Management
			Pharmacologic
				Prophylaxis in Neutropenic Patients Before Neutropenic Fever Develops
				Antimicrobial Therapy in Neutropenic Fever and Sepsis
				Hematopoietic Growth Factors
				Granulocyte Transfusions
			Non-pharmacologic
			Management Algorithm
		Prognosis
		Conclusion and Summary
		References
	94 Sepsis and Septic Shock in Cancer Patients
		Introduction
		Terminology
		Etiology
		Pathophysiology
		Epidemiology
			Mortality
		Clinical Features
		Diagnosis
		Management
		Prognosis
		Conclusion
		References
	95 Management of Multidrug-Resistant Enterobacteriaceae in Critically Ill Cancer Patients
		Introduction
		How Bacterial Resistance Develops
		Multidrug Resistance Definitions
		Epidemiology
		Treatment in AmpC and ESBL
			Beta-Lactamase Inhibitors (BL/BLIs)
			Carbapenems
			Aminoglycosides
			Tigecycline
			Fosfomycin
			Fluoroquinolones
		Treatment in Carbapenem-Resistant Enterobacteriaceae (CRE)
			Monotherapy Versus Combined Therapy
			Carbapenems
			Polymyxins
			Tigecycline
			Aminoglycosides
			Fosfomycin
			New Molecules
				Ceftazidime-Avibactam
				Ceftolozane-Tazobactam
				Ceftaroline-Avibactam
				Novel Carbapenemase
				Plazomicin
				Eravacycline
		Strategies in Carbapenem-Resistant Bacteria
		Other Measures to Prevent MDR Bacterial Infections
		Conclusions
		References
	96 Fungal Infections in Cancer Patients
		Introduction
		Candidiasis in the ICU
			Etiology
			Epidemiology
			Clinical Features
				Clinical Aspects of IC in the ICU
			Diagnosis
				Prediction Rules for IC in ICU Patients
			Management
				Pharmacologic
					Treatment of IC in the ICU
						Prophylaxis
						Preemptive Therapy for IC in ICU Patients with Cancer
						Treatment of Documented Candida Infection
				Nonpharmacologic
				Management Algorithm (See Fig. 2)
			Prognosis
		Aspergillosis in the ICU
			Etiology
			Epidemiology
			Pathophysiology
			Clinical Features
			Diagnosis
			Management
				Pharmacologic
				Nonpharmacologic
			Prognosis
		Mucormycosis and Other Unusual Fungal Infections in the ICU
			Pneumocystis jiroveci Pneumonia (PJP)
				Infection Control
				Antifungal Stewardship
		Conclusions and Future Directions
		References
	97 Viral Infections in Critically Ill Cancer Patients
		Introduction
		Clinically Relevant Viruses in the Critically Ill Patient
			Herpes Simplex Virus and Varicella-Zoster
				Epidemiology
				Clinical Manifestations
				Diagnostics
				Treatment
				Prevention
			Cytomegalovirus
				Epidemiology
				Clinical Manifestations
				Diagnostics
				Treatment
				Prevention
			Influenza
				Epidemiology
				Clinical Manifestations
				Diagnostics
				Treatment
				Prevention
			Respiratory Syncytial Virus
				Epidemiology
				Clinical Manifestations
				Diagnostics
				Treatment
				Prevention
		Less Frequent Viral Infections
			Enterovirus
			Adenovirus
		Arboviruses
			Dengue
			Chikungunya
			Zika
		Ebola
		Seasonal Viruses
		References
	98 Bacterial and Atypical Infections in Critically Ill Cancer Patients
		Introduction
		Etiology
			Gram-Positive Bacteria
			Gram-Negative Bacteria
		Epidemiology
		Pathophysiology
			Anatomical Barriers Disruption
			Neutropenia
			Malnutrition
			Dysbiosis
		Clinical Features
			Bloodstream Infections
			Ventilator-Associated Pneumonia
			Respiratory Failure
			Urinary Tract Infections
			Community and Healthcare-Acquired Pneumonia
			Surgical Site Infections
			Febrile Neutropenia
			Sepsis
			Pseudomembranous Colitis and C. difficile-Associated Diarrhea
		Diagnosis
		Management
			Pharmacologic
			Non-pharmacologic
		Prognosis
		Summary
		References
	99 Catheter- and Device-Related Infections in Critically Ill Cancer Patients
		Introduction
			Background
			Type of Central Venous Catheters
			Risk Factors
			Pathogenesis of CLABSI
				Endoluminal Route
				Extraluminal Route
				Biofilm Formation
				Microbiology
		Clinical Manifestations and Definitions
			Local Catheter Infections
				Phlebitis
				Exit Site Infection
				Tunnel Infection
				Pocket Infection
			Systemic Manifestations of Catheter Infections
		Diagnosis
			Catheter-Sparing Diagnostic Techniques
			Diagnostic Methods Requiring Catheter Removal
				Semiquantitative Roll-Plate Catheter Culture
				Quantitative Catheter Segment Cultures
		Prevention
			Antimicrobial Impregnation and Coating of Catheters
			Antimicrobial Lock Therapy
		Management
			Non-pharmacological Treatment (Catheter Management)
				Catheter Removal
				Catheter Exchange over a Guidewire Using Antimicrobial-Coated CVC
				Catheter Salvage Lock Therapy
			Pharmacological Therapy (Systemic Antimicrobial Therapy)
				Coagulase Negative Staphylococcus Species (CoNs)
				Staphylococcus aureus
				Enterococcus Species
					Gram-Negative Bacilli
					Candida Species
					Other Gram-Positive Organisms
			Management Algorithm
		Conclusion
		References
	100 Nosocomial Infections and Ventilator-Associated Pneumonia in Cancer Patients
		Nosocomial Infections
			Introduction
			Incidence, Etiology, and Impact of Nosocomial Infections
			Risk Factors
			Treatment and Prevention of Nosocomial Infections
				Strategies for the Prevention of Nosocomial Infections
		Nosocomial Pneumonia
			Definition of Ventilator-Associated Pneumonia
			Incidence of VAP
			Pathogenesis of VAP
			Etiology of VAP
			Diagnosis of VAP
			Microbiological Methods for Diagnosis of VAP
			Biomarkers for Diagnosing VAP
			Antimicrobial Treatment
			Guidelines for Management of Nosocomial Pneumonia
				Pharmacokinetics of Antibiotics in the Lung
				Non-resolving Ventilator-Associated Pneumonia
			Prevention of VAP
			Non-ventilated Hospital-Acquired Pneumonia (NV-HAP) or Hospital-Acquired Pneumonia (HAP)
		Catheter-Associated Urinary Tract Infections (CAUTI)
			Definition
			Risk Factors
			Management of Nosocomial CAUTI
			Prevention of CAUTI and CAUTI Bundle
		Surgical Site Infection
			Prophylaxis for SSI
				Antimicrobial Prophylaxis
				Other Methods for Prevention of SSI
		Conclusion
		References
	101 Parasites in Cancer Patients
		Introduction
		Epidemiology
		Toxoplasma gondii
			Characteristics
			Clinical Manifestations
			Treatment
		Ascaris lumbricoides (Round Worm)
			Characteristics
			Clinical Manifestations
			Treatment
		Taenia spp.
			Characteristics
			Clinical Manifestations
			Treatment
		Strongyloides stercoralis
			Characteristics
			Clinical Manifestations
			Treatment
		Trichuris trichiura (Whipworm)
			Characteristics
			Clinical Manifestations
			Treatment
		Giardia lamblia
			Characteristics
			Clinical Manifestations
			Treatment
		Cryptosporidium spp.
			Characteristics
			Clinical Manifestations
			Treatment
		Cystoisospora belli
			Characteristics
			Clinical Manifestations
			Treatment
		Entamoeba spp.
			Characteristics
			Clinical Manifestations
			Treatment
		Blastocystis hominis
			Characteristics
			Clinical Manifestations
			Treatment
		Conclusions
		References
	102 Tropical Diseases in Cancer Patients
		Introduction
		Malaria
			Etiology
			Epidemiology
			Pathophysiology
			Clinical Features
			Diagnosis
			Management and Prognosis
		Dengue Fever
			Etiology
			Epidemiology
			Pathophysiology
			Clinical Features
			Diagnosis
			Management
		Chikungunya Fever
			Etiology
			Epidemiology
			Clinical Presentation
			Diagnosis
			Management and Prognosis
		Zika
			Etiology
			Epidemiology
			Pathophysiology
			Clinical Features
			Diagnosis
			Management
		Yellow Fever
			Etiology and Epidemiology
			Pathophysiology
			Clinical Findings
			Diagnosis
			Management and Prognosis
		Conclusion
		References
	103 Skin and Soft Tissue Infections Among Cancer Patients
		Necrotizing Soft Tissue Infections
			Introduction
			Etiology
			Epidemiology
			Pathophysiology
			Clinical Features
			Diagnosis
			Management
			Prognosis
		Cellulitis, Erysipelas, and Skin Abscess
			Introduction
			Etiology
			Pathophysiology
			Clinical Features
			Diagnosis
			Management
		Perirectal Infections
			Introduction
			Etiology, Epidemiology, and Pathophysiology
			Clinical Features and Diagnosis
			Management
		Ecthyma Gangrenosum
		Infected Tumors
		References
Part XIV: Special Patient Populations
	104 Practical Approach to the Critically Ill Obstetric Patient with an Oncological Disease
		Introduction
		Epidemiology
			Physiological Changes Associated with Pregnancy
				Cardiovascular
				Pulmonary
				Hematological
				Gastrointestinal
				Renal
			State Identification
		Management
			Chemotherapy
			Radiotherapy
			Main Complications Associated with Surgical Procedures in Pregnant Patients with Cancer
			Types of Cancer Associated with Pregnancy
				Breast Cancer
				Cervical Cancer
				Choriocarcinoma
				Melanoma
			Hematological Neoplasms
				Thyroid Cancer
			Abortion
			Time to End the Pregnancy
			Management Algorithm
		Prognosis
			Breast Cancer
			Cervical Cancer
			Leukemia and Lymphoma
			Melanoma
		References
	105 What the Intensivist Needs to Know About Leukemia Patients
		Introduction
		Tumor Lysis Syndrome
			Pathophysiology
			High-Risk Patients
			Diagnosis
			Treatment
				Electrolyte Abnormalities
				Acute Kidney Injury
			Conclusion
		Hyperleukocytosis
			Pathophysiology
			Clinical Symptoms
			Diagnosis
			Treatment
				Intravenous Hydration
				Hydroxyurea
				Cytarabine
				Leukapheresis
				Corticosteroids
			Conclusion
		Diffuse Alveolar Hemorrhage
			Pathophysiology
			Clinical Symptoms
			Diagnosis
			Treatment
			Conclusion
		Cytokine Release Syndrome
			Pathophysiology
			Clinical Symptoms and Management
			Conclusion
		References
	106 What the Intensivists Need to Know About Critically Ill Lymphoma Patients
		Introduction
		Tumor Lysis Syndrome
		Hypercalcemia of Malignancy
		Lactic Acidosis
		Superior Vena Cava Syndrome
		Neutropenic Fever and Sepsis
		Hemophagocytic Syndromes (Hemophagocytic Lymphohistiocytosis, HLH)
		Syndrome of Inappropriate Secretion of Antidiuretic Hormone
		Rituximab-Induced Progressive Multifocal Leukoencephalopathy
		Conclusion
		References
	107 What the Intensivists Need to Know About Critically Ill Myeloma Patients
		Introduction
		Renal
		Cardiovascular
		Infection
		Pulmonary
		Metabolic
		Nervous System
		Hematologic
		Conclusion
		References
	108 What the Intensivist Needs to Know About Hematopoietic Stem Cell Transplantation?
		Introduction
		Types of Transplant
		Overview of the Transplant Process
		Complications After Autologous HSCT
		Complications of Allogeneic HSCT
			Pre-engraftment Complications
			Early Post-engraftment Complications
			Late Post-engraftment Complications
		End of Life Issues in HSCT Patients Admitted to the ICU
		References
	109 Radiation Therapy Complications Leading to Critical Illness
		Introduction
		Effects of Radiation Therapy
		Radiation Therapy Delivery
		Radiation Therapy Modalities
		Radiation Emergencies
			Spinal Cord Compression
			Bone Metastases
			Brain Metastases
			Superior Vena Cava Syndrome
			Uncontrolled Bleeding
		References
Part XV: Critical Care Procedures
	110 Management of Airway in the Cancer Patients
		Introduction
		Etiology
		Clinical Features
		Diagnosis
		Management
			Non-pharmacologic Airway Management
			Management Algorithm
		Prognosis
		Summary
		References
	111 Critical Care Procedures by the Advanced Practice Provider
		Introduction
		Role of the Advanced Practice Provider
		Advanced Practice Providers in the Intensive Care Unit
		Invasive Procedure Education and Training
		Outcomes of Procedures Performed by APPs
		Oncologic Considerations
		CVC and Arterial Line Insertion Site Selection in the Oncologic Patient
		Central Venous Catheters
		Arterial Lines
		Intubation
		Other Invasive Procedures
		Conclusion
		References
	112 Point-of-Care Ultrasound for Oncologic Critical Care
		Introduction
		Focus Assessed Transthoracic Echo (FATE)
			Parasternal Long-Axis (PLAX) View
			Parasternal Short-Axis (PSAX) View
			Apical Four-Chamber View
			Subcostal Four-Chamber View
		Inferior Vena Cava Collapsibility
			Technique
			Benefits and Pitfalls
		Thoracic Ultrasound
			Technique
			Pneumothorax
			Pleural Effusions
			Interstitial Fluid
			Pneumonia
			Appropriateness for Extubation
		Intracranial Pressure
			Technique
			Benefits and Pitfalls
		Venous Thromboembolism
			Technique
			Benefits and Pitfalls
		Conclusion
		References
	113 Interventional Radiology Procedures in Critically Ill Cancer Patients
		Introduction
		Etiology
			Central Venous Access
			Enteric Access
			Drainage of Obstructed or Infected Fluid
			Correction of Vascular Obstruction
			Occlusion of Active Bleeding
			Pulmonary Embolus Prevention and Treatment
		Epidemiology
		Pathophysiology
		Clinical Features
			Central Venous Access
			Enteric Access
			Drainage of Obstructed or Infected Fluid
			Correction of Vascular Obstruction
			Occlusion of Active Bleeding
			Pulmonary Embolus Prevention and Treatment
		Diagnosis
			Central Venous Access
			Enteric Access
			Drainage of Obstructed or Infected Fluid
			Correction of Vascular Obstruction
			Occlusion of Active Bleeding
			Pulmonary Embolus Prevention and Treatment
		Management
			Central Venous Access
			Enteric Access
				Feeding Gastrostomy Tubes
				Feeding Gastrojejunostomy Tubes
				Feeding Jejunostomy Tubes
				Venting Gastrostomy Tubes
				Venting Esophageal-Gastrostomy Tubes
			Drainage of Obstructed or Infected Fluid
				Abscess Drains
				Biliary and Cholecystostomy Drains
				Nephrostomy and Cystostomy Drains
				Pleural Drainage
			Correction of Vascular Obstruction
			Occlusion of Active Bleeding
			Pulmonary Embolus Prevention and Treatment
		Prognosis
			Central Venous Access
			Enteric Access
			Drainage of Obstructed or Infected Fluid
			Correction of Vascular Obstruction
			Occlusion of Active Bleeding
			Pulmonary Embolus Prevention and Treatment
		Summary
		References
Part XVI: Perioperative Management of the Surgical Cancer Patient
	114 Enhanced Recovery After Surgery (ERAS) in the Oncologic Patient
		Introduction
		Preoperative Management of the Oncologic Patient
			Preoperative Education and Counseling
			Preoperative Nutrition
			Preoperative Medical Optimization
			Preoperative Fasting
			Pain Management Plan
		Intraoperative Management of the Oncologic Patient
			Airway Management
			Nasogastric Intubation
			Goal Directed Fluid Therapy (GDFT)
			Pain Management (Multimodal Analgesia)
			Thromboembolic Prophylaxis
			Thermoregulation
			Glycemic Control
		Postoperative Management of the Oncologic Patient
			Thromboembolic Prophylaxis
			Multimodal Pain Management
			Early Ambulation
			Rehabilitation Services
			Postoperative Nausea Vomiting Prevention
			Nasogastric Intubation
			Early Feeding
			Postoperative Ileus Prophylaxis
			Transurethral Catheter Removal
			Goal-Directed Fluid Therapy
			Airway and Ventilatory Management
			Postoperative Hyperglycemia Management
			Flap Monitoring
		Oncologic Considerations and Postoperative Complications
			Outcomes and Economic Impact of Enhanced Recovery After Surgery in the Surgical Oncology Population
		Appendix
		References
	115 Neurosurgery and Post-Surgical Care of the Critically Ill Cancer Patients
		Introduction
		Etiology
		Epidemiology
		Clinical Features
			Gliomas
			Meningiomas
		Diagnosis
		Surgical Management
			Craniotomy
			Awake Craniotomy
			Stereotactic Procedures
			Burr Holes
			Craniectomy
		Anesthetic Management
		Pharmacologic Management
		Intraoperative Adverse Incidents
		Postoperative Management
		Postoperative Complications
			Postoperative Neurological Deficits and/or Changes
		Prognosis
		Conclusion
		References
	116 Skull Base and Endoscopic Procedures in Cancer Patients
		Introduction
		Etiology
		Epidemiology
		Pathophysiology
			Cerebral Blood Flow
				Metabolism
				Carbon Dioxide
				Oxygen
				Arterial Pressure
				Viscosity
				Temperature
		General Considerations
			Intracranial Pressure
			Herniation Syndrome
			Clinical Features
			Diagnosis
		Intraoperative Management
			Anesthesia Induction
			Maintenance of Anesthesia
			Optimizing Cerebral Venous Drainage
			Intraoperative Fluid Management
			Emergence
		Postoperative
			Hemorrhage
			Cerebrospinal Fluid Leak
			Meningoencephalocele
			Meningitis
			Cerebral Infarction
			Seizures
			Nausea and Vomiting
			Elevated Intracranial Pressure (ICP)
		Conclusion
		References
	117 Neurosurgery and Spine Procedures in Cancer Patients
		Introduction
		Etiology
		Epidemiology
		Pathophysiology
		Clinical Features
		Diagnosis
		Management
			Pharmacologic
				Antibiotic Prophylaxis
				Intraoperative Neurophysiology Monitoring and Drug Pharmacology
				Anesthetic Effects on Evoked Potentials
				Blood Loss during the Intraoperative Period
		Non-pharmacologic
			Surgical Approaches and Positioning
			Airway Management
			Perioperative Vision Loss
		Management Algorithm
			Postoperative Airway Management
			Postoperative Neurologic Monitoring
			Postoperative Vision Assessment
			Coagulopathies
			Pain Management
			Malnutrition
			Prevention of Thromboembolism and Early Mobilization
		Conclusion/Summary
		Cross-References
		References
	118 Neurosurgery and Pituitary Resection in Cancer Patients
		Introduction
		Etiology
		Epidemiology
		Pathophysiology
			Excess Hormone Production
			Mechanical Effects
			Impaired Pituitary Function
		Diagnosis
		Management
			Pharmacologic Management
			Non-pharmacologic Management
				Radiation
				Surgical
				Preoperative Assessment
				Acromegaly
				Cushing´s Disease
				Intraoperative Management
				Postoperative Period
		Prognosis
		Conclusion
		References
	119 Anesthesia for Free Flap Reconstruction After Head and Neck Surgical Resection
		Introduction
		Etiology
		Epidemiology
		Pathophysiology
		Clinical Features
			Nasal and Paranasal Sinuses
			Nasopharynx
			Hypopharynx, Larynx, and Trachea
			Oral Cavity and Oropharynx
		Diagnosis
		Management
			Pharmacologic
			Non-pharmacologic
		Specific Anesthetic Considerations
			Free Flap Transfer
				Management Algorithm
			Primary Ischemia
			Reperfusion
			Secondary Ischemia
			Causes of Flap Failure
			Preoperative
			Perioperative Period
			Physiological Considerations
			Viscosity
			Fluid Therapy
			Monitoring
			Temperature
			Positioning
			Tension Control/Vasoactive Agents
			Other Drugs
			Postoperative Period
			Postoperative Care
		Prognosis
		Conclusion
		References
	120 Head and Neck Surgery in Oncologic Patients: Laryngectomy and Radial Neck Dissection
		Introduction
		Etiology
		Epidemiology
		Clinical Features
			Pathophysiology
		Diagnosis
		Management
			Anesthetic Management
				Preoperative
					Intraoperative
					Considerations
					Postoperative: Total Laryngectomy
						Pharyngocutaneous Fistula
						Hypocalcemia
						Infection
						Hypertension
						Postoperative: Partial Laryngectomy
						Postoperative: Radical Neck Dissection
		Prognosis
		Conclusion
		References
	121 Plastic Surgery and Flap Graft Management of Radial Forearm, VRAM, and TRAM Flaps in Critically Ill Cancer Patients
		Introduction
		Etiology
		Epidemiology
		Pathophysiology
		Diagnosis
		Clinical Features
			Radial Forearm Free Flap
			Vertical Rectus Abdominis Myocutaneous Flap (VRAM)
			Transverse Rectus Abdominis Myocutaneous Flap (TRAM)
		Management
			Non-pharmacologic
			Pharmacologic
		Prognosis
		Conclusion
		References
	122 Perioperative Care of the Thoracic Oncologic Patient Undergoing EBUS, Thoracotomy, and Pneumonectomy
		Introduction
		Etiology
		Epidemiology
		Pathophysiology
		Clinical Features
		Diagnosis
			Endobronchial Ultrasound (EBUS)
			Staging
		Management
			Pharmacologic Management
			Non-pharmacologic Management
				Radiation Therapy
				Surgical Resection
					Thoracotomy
					Pneumonectomy
					Preoperative Risk Assessment
					Enhanced Recovery After Thoracic Surgery (ERATS)
				Anesthetic Management of the EBUS Patient
					Preoperative Evaluation
					Anesthetic Technique and Airway Considerations
					Procedural Complications
		Prognosis
		Conclusion
		References
	123 Thoracic Surgery and Rigid Bronchoscopy
		Introduction
		Etiology
			Malignant CAO
			Nonmalignant CAO
		Epidemiology
		Pathophysiology
		Clinical Features
		Diagnosis
		Preoperative Assessment
		Procedure
		Interventions
			Mechanical Debulking and Dilation
			Thermal Therapy
			Cold Therapy
			Airway Stents
				Silicone Stents
				Metal Stents
		Management
			Pharmacologic Management
			Nonpharmacologic Management
			Postoperative Management
		Prognosis
		Conclusion
		References
	124 Thoracic Surgery and Esophagectomy
		Introduction
		Etiology
		Epidemiology
		Pathophysiology
		Clinical Features
		Diagnosis
			Staging
		Management
			Pharmacologic
				Chemotherapy and Radiation
			Non-pharmacologic
				Endoscopic Management
				Surgical Management
				Enhanced Recovery After Surgery
				Anesthetic Management
				Postoperative Complications
		Management Algorithm
		Prognosis
		Conclusion
		References
	125 Tumor Thrombectomy Overview and General Concepts
		Introduction
		Etiology
		Epidemiology
		Pathophysiology
		Clinical Features
		Diagnosis
		Management
		Prognosis
		Conclusion
		References
	126 Perioperative Management of the Oncologic Patient Undergoing Gastrointestinal Surgery
		Introduction
		Etiology
		Epidemiology
		Pathophysiology
		Clinical Features
		Diagnosis
		Management
		Prognosis
		Postoperative ICU Management Concerns
		Conclusion
		References
	127 Perioperative Management of the Oncologic Patient Undergoing Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemo...
		Introduction
		Etiology and Epidemiology
		Management
		Complications
		Prognosis
		References
	128 Care of the Postoperative Patient with Liver Cancer in the Intensive Care Unit
		Introduction
		Etiology
		Epidemiology
		Pathophysiology
		Clinical Features
		Diagnosis
		Management
		Prognosis
		Conclusion
		References
	129 Pancreatic Surgery in Cancer Patients
		Introduction
		Etiology
		Epidemiology
		Pathophysiology
		Clinical Features
		Diagnosis
		Management
		Pancreatic Cancer Management Algorithm
		Enhanced Recovery After Surgery (ERAS) Practice for Pancreatic Surgery
		Anesthesia Management
		Preoperative Anesthesia Considerations
		Intraoperative Anesthesia Management
			Induction
			Maintenance
			Emergence from Anesthesia
			Postoperative Concerns and Possible Complications
				Immediate Postoperative Care
				Most Common Complications
				Length of Surgical Procedure
				Postpancreatectomy Hemorrhage (PPH)
		Prognosis
		Conclusion
		References
	130 Perioperative Management of the Genitourinary Oncologic Patient Undergoing Partial/Radical Nephrectomy
		Introduction
		Etiology
			Cigarette Smoking
			Obesity
			Hypertension
			Genetic Predisposition
		Epidemiology
		Pathophysiology
		Clinical Manifestations
		Diagnostic Evaluation
		Tissue Diagnosis/Staging
		Treatment
		Management
			Anesthesia Induction and Intraoperative Considerations
			Emergence and Pain Management
			Postoperative Management and Complications
		Conclusion
		References
	131 Total Abdominal Hysterectomy, Bilateral Salpingo-oophorectomy, and Pelvic Lymphadenectomy in Cancer Patients
		Introduction
		Etiology
		Epidemiology
		Pathophysiology
		Clinical Features
		Diagnosis
		Surgical Staging
		Management
			Treatment Recommendations
			Enhanced Recovery After Surgery
			Preoperative and Intraoperative Management
			Pharmacological Management
			Non-pharmacological Management
			Surgical Method
			Pneumoperitoneum
			Anesthetic Management
			Postoperative Care
			Prognosis
		Conclusion
		References
	132 Orthopedic Surgery and Femoral/Humeral Fracture Repairs
		Introduction
		Etiology
		Epidemiology
		Clinical Features
		Diagnosis
		Management
			Preoperative Anesthetic Assessment
			Room Setup
			Induction and Maintenance of General Anesthesia
			Massive Transfusion Considerations
			Wake-Up and Transport
			Postoperative Care
		Prognosis
		Conclusion
		References
	133 Magnetic Resonance Imaging (MRI) for the Acute Care Oncology Patient
		Introduction
		Etiology and Epidemiology
		MRI Principles and Equipment
		Management
			Pharmacologic
			Non-pharmacologic
			Management Algorithm
		Prognosis
		Conclusion
		References
	134 Perioperative Management of Breast Cancer Surgery
		Introduction
		Etiology
		Epidemiology
		Pathophysiology
		Clinical Features of Breast Cancer and Surgery
			Latissimus Dorsi (LD) Flap
			Transverse Rectus Abdominis Myocutaneous (TRAM) Flap
			Free Flap (FF)
		Diagnosis and Diagnostic Imaging
		Treatment of Breast Cancer
		Prognosis
			Cardiovascular Health
			Bone Health
			Risk of Secondary Primary Malignancies
			Breast Cancer-Related Lymphedema
			Thromboembolic Events (TEs)
			Adherence and Compliance
			Lifestyle Management
		Complications After Breast Cancer Surgery
		Enhanced Recovery After Surgery
			Preoperative Management
			Intraoperative Management
			Postoperative Considerations
		Conclusion
		References
Part XVII: Pain Management
	135 Acute Pain in Critical Care Oncologic Patients
		Introduction
		Etiology
		Epidemiology
		Clinical Features
			Characteristics of Cancer Pain
			Pathophysiology of Pain
			The Importance of Preventing Acute to Chronic Pain
			Cancer Pain Assessment Versus Acute Pain Assessment
			Management
		Comfort Care
		Non-pharmacological Methods
		Pharmacologic Therapy (Fig. 2)
			Interventional Pain Management: Peripheral Nerve Blocks, Neuro-axial Blocks, etc.
			Opioid
			Non-opioids
		Conclusion
		References
	136 Pathophysiology, Assessment, and Treatment of Chronic Cancer Pain in Critically Ill Patients
		Pathophysiology
		Assessment
		Management
		Nonpharmacological Strategies
		Opioid Therapy
		Adjuvant Pharmacotherapy
		Interventional Options
		Regional Anesthetic Technique
		Neurolytic Procedures
		Neuraxial Procedures
		Cementation of Bone
		Conclusion
		References
	137 Substance Withdrawal in ICU Environment
		Introduction
		Etiology
		Epidemiology
		Pathophysiology
		Clinical Features
		Diagnosis
		Management
			Opioid Withdrawal Syndrome Management
				Pharmacologic
				Non-pharmacologic
			Benzodiazepine Withdrawal Syndrome Management
				Pharmacologic
				Non-pharmacologic
			Alcohol Withdrawal Syndrome Management
				Pharmacologic
					α2-Adrenergic Agonist (Dexmedetomidine and Clonidine)
					Propofol
					Antipsychotic Drugs
					Ketamine
					Antiepileptic Drugs
					Barbiturates
				Non-pharmacologic
		Prognosis
		References
Part XVIII: Ethics and Palliative Care
	138 Ethical Issues at the End-of-Life in the Cancer Patient
		Introduction
		End-of-Life Care: Death Is Not Easy to Talk About
			Advance Care Planning
			Physical End-of-Life Care
			Psychosocial End-of-Life Issues
		Dealing with ``Medical Futility´´ in a Cancer Care Center Intensive Care Unit
			Confounding Concerns: Common Issues That Come with Futility
			The Texas Advance Directives Act (TADA)
			Suggestions for Physicians
		Steps to Consider in Talking with Families or Surrogate Decision-Makers
			Recommended Methods
		Cardiopulmonary Resuscitation in the Cancer Patient
			Historical Background
			Application
		Communication
		Physician-Assisted Suicide and Euthanasia: A Contemporary Ethical Question
		Ethics Consultation
		Conclusion
		References
	139 Palliative Care in Critically Ill Cancer Patients
		Introduction
		Symptom Management
			Incidence
			Symptom Assessment Tools
			Pain
			Dyspnea
				Pharmacological Treatments
				Non-pharmacological Treatments
			Delirium
			Thirst and Xerostomia
		Spiritual Care for Critically Ill Patients and Their Caregivers
		Family and Caregivers
			Communicating with Patients and Families; Goals of Care Conferences/Family Meetings
		Integration of Palliative Care
			Barriers to Early Integration and Referral to Palliative Care
		Withdrawing and Withholding Medical Technology
			Artificial Nutrition and Hydration
		Impending Death, Communication, and ``Anticipatory Guidance´´
		Conclusion
		References
Part XIX: Pediatric Oncologic Critical Care
	140 Oncologic Emergencies in Pediatric Critical Care
		Introduction
		Infections
			Febrile Neutropenia
			Febrile Neutropenia-Associated Complications
				Respiratory Infections
				Bacteremia
				Neutropenic Enterocolitis
		Shock in Pediatric Oncology
			Septic Shock
				Assessment
				Treatment
			Cardiogenic Shock
				Assessment
				Management of Cardiogenic Shock
		Hyperleukocytosis
			Pathophysiology
			Treatment
				Leukapheresis
				Exchange Transfusion
				Supportive Care
		Tumor Lysis Syndrome
			Pathophysiology
				Hyperuricemia
				Hyperkalemia
				Hyperphosphatemia
				Hypocalcemia
			Definition
				Laboratory TLS
				Clinical TLS
			Incidence and Risk Factors
				Type of Tumor with Low Risk
				Type of Tumors with Intermediate Risk
				Type of Tumors with High Risk
			Assessment and Monitoring
			Treatment
				Management of Hyperuricemia
		Pediatric Mediastinal Tumors
			Superior Mediastinal Syndrome (SMS)
				Perioperative Evaluation
				Pediatric ICU Considerations
				Anesthetic Considerations
				Tumor Evaluation
				Emergency Treatment
		Increased Intracranial Pressure (ICP)
			Primary and Metastatic Brain Tumors
				Effects of Radiotherapy
				Cytotoxic Edema
			Communicating and Non-communicating Hydrocephalus
			Clinical Presentation
				Increased ICP
				Hydrocephalus
			Management
				Dexamethasone
				Hyperosmolar Therapy
				Procedural Therapy
				Other Therapies
		Conclusions
		References
	141 Pain Management of Children with Terminal Cancer in the Critical Care Unit
		Introduction
		Etiology
		Epidemiology
		Pathophysiology
		Clinical Features
		Diagnosis (Pain Assessment)
		Management
			Pharmacologic Management
				Intractable Pain
				Palliative Sedation Therapy
			Nonpharmacologic Pain Management
			Management Algorithm
		Conclusion
		References
	142 Delirium in the Pediatric Critical Care Oncologic Patient
		Introduction
		Etiology
		Pathophysiology
		Epidemiology
			Incidence
			Risk Factors
		Clinical Features
		Diagnosis
		Prognosis
		Management
			Non-pharmacologic
			Pharmacologic
			Management Algorithm
		Conclusion
		References
	143 Chimeric Antigen Receptor (CAR) T-Cell Therapy in the Pediatric Critical Care
		Introduction
		Indications and Eligibility for CAR Therapy in Pediatrics
		CAR Manufacturing
		Bridging Chemotherapy and Preparative Lymphodepletion Regimens
		Chimeric Antigen Receptor Infusion
		Cytokine Release Syndrome (CRS)
		CAR T-Cell-Related Encephalopathy Syndrome (CRES)
		CAR T-Cell Therapy-Related Hemophagocytic Lymphohistiocytosis (HLH)
		Supportive Care Issues and Pediatric Considerations
		Tumor Lysis Syndrome
		Pseudo-progression
		Other Immune Effector Cell Therapies
		Late Effects and Long-Term Follow-Up
		References
Index