Resumen
Objective: To describe the clinical characteristics of pediatric oncology patients who were diagnosed with Febrile Neutropenia (NF) admitted for the first time to the Intensive Care Unit (ICU) of the National Pediatric Oncology Unit (UNOP). Methods: This is a descriptive and retrospective study where a total of 211 patients who developed NF and required admission to the ICU, between the years 2017 to 2021, were characterized. Results: The average age was 8 years, 46% were male and 54% female. 72.77% had a severe level of neutropenia and leukemia (81.99%) was the prominent oncologic diagnosis. Within all treatments, 38.39% of the patients were in the induction phase. An associated infectious agent was identified in 33.18%. Gram-negative bacteria were the most frequent causative infectious agent (13.74%). The mean length of stay in the ICU was 6.75 ± 5.79 days. 91.62% of patients did not require mechanical ventilation and the most frequent complication associated with NF was sepsis in 65.88% of cases. Conclusion: Most cases of Febrile Neutropenia are severe, hematological malignancies (ALL and AML) are the most frequent underlying disease for the development of NF and Gram-negative bacteria are the most frequent causative infectious agent. Most patients do not require mechanical ventilation and the most frequently associated complications are Sepsis and Pneumonia
Citas
Organización Panamericana de la Salud. El 55% de los niños y adolescentes con cáncer se curan en América Latina y el Caribe. OPS; 2022. https://www.paho.org/es/noticias/15-2-2022-55-ninos-adolescentes-con-cancer-se-curan-america-latina-caribe
Islami, F., Ward, E. M., Sung, H., Cronin, K. A., Tangka, F. K. L., Sherman, R. L., et al. (2021). Annual report to the nation on the status of cancer, part 1: National cancer statistics. Journal of the National Cancer Institute, 113(12), 1648–1669. https://doi.org/10.1093/jnci/djab131
Kebudi, R., & Kizilocak, H. (2018). Febrile neutropenia in children with cancer: Approach to diagnosis and treatment. Current Pediatric Reviews, 14(3), 204–209. https://doi.org/10.2174/1573396314666180508121625
Rivera-Salgado, D., Valverde-Muñoz, K., & Ávila-Agüero, M. L. (2018). Neutropenia febril en niños con cáncer: Manejo en el servicio de emergencias. Revista Chilena de Infectología, 35(1), 62-71. https://doi.org/10.4067/s0716-1018201800010006
Navarrete, C. M. (2020). Microorganismos presentes en sangre de pacientes oncológicos pediátricos con fiebre y neutropenia sin foco, en el Hospital Solón Espinosa Ayala “SOLCA”, núcleo Quito, en el periodo de enero a diciembre de 2018. (Pontificia Universidad Católica del Ecuador, Facultad de Medicina., Ed.).
Freifeld, A. G., Bow, E. J., Sepkowitz, K. A., Boeckh, M. J., Ito, J. I., Mullen, C. A., et al (2011). Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the Infectious Diseases Society of America. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 52(4), e56–e93. https://doi.org/10.1093/cid/cir073
Lehrnbecher, T., Phillips, R., Alexander, S., Alvaro, F., Carlesse, F., Fisher, B., et al. International Pediatric Fever and Neutropenia Guideline Panel. (2012). Guideline for the management of fever and neutropenia in children with cancer and/or undergoing hematopoietic stem-cell transplantation. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 30(35), 4427–4438. https://doi.org/10.1200/JCO.2012.42.7161
Asturias, E. J., Corral, J. E., & Quezada, J. (2010). Evaluation of six risk factors for the development of bacteremia in children with cancer and febrile neutropenia. Current oncology (Toronto, Ont.), 17(2), 59–63. https://doi.org/10.3747/co.v17i2.453
Santolaya, M. E., Contardo, V., Torres J. P., López-Medina, E., Rosanova, M. T., Álvarez, A. M., Gutiérrez, V., et al. (2021). Management of episodes of febrile neutropenia in children with cancer. Consensus of the Latin American Society of Pediatric Infectious Diseases 2021. Revista chilena de infectología, 38(6), 857-909. https://dx.doi.org/10.4067/s0716-10182021000600857
Robledo de la Hoz, T.I & Parodi Saltaren, C.J. (2018). Factores de riesgo asociados a ingreso a ucip en pacientes con neutropenia febril. universidad libre seccional barranquilla postgrado en pediatría barranquilla. https://repository.unilibre.edu.co/bitstream/handle/10901/17742/1.129.572.863.pdf?sequence=1&isAllowed=y
Maldonado, M. E., Acuña, M., Álvarez, A. M., Avilés, C. L., Maza, V. de la, Salgado, C., et al. (2018). Microorganismos aislados de hemocultivos en niños con cáncer y neutropenia febril de alto riesgo en cinco hospitales de Santiago, Chile, período 2012-2015. Revista chilena de infectología, 35(2), 140-146. https://doi.org/10.4067/s0716-10182018000200140
Arroyave, T., Puertas, J. D., Beltrán, R. E., Salgado, T. M., Ramírez, D. C., Arroyave, D., Ruiz, A. C., Londoño, L. F., & Jaimes, F. A. (2019). Características de los pacientes adultos con neutropenia febril en un hospital universitario (Medellín, 2012-2016). Medicina UPB, 38(2), 108-113. https://doi.org/10.18566/medupb.v38n2.a02
Israels, T., Renner, L., Hendricks, M., Hesseling, P., Howard, S., & Molyneux, E., Paediatric Oncology in Developing Countries. (2013). SIOP PODC: recommendations for supportive care of children with cancer in a low-income setting: Supportive Care Guidelines for Low-Income Settings. Pediatric Blood & Cancer, 60(6), 899–904. https://doi.org/10.1002/pbc.24501
Medina, M. & Ramos, J. (2017). Caracterización de los pacientes que ingresan a UCIP por neutropenia febril. clínica prevenir Barranquilla 2015 - 2016. Recuperado de: https://hdl.handle.net/10901/10721.
Avilés-Robles, M., Schnur, J. J., Dorantes-Acosta, E., Márquez-González, H., Ocampo-Ramírez, L. A., & Chawla, N. V. (2022). Predictors of septic shock or bacteremia in children experiencing febrile neutropenia post-chemotherapy. Journal of the Pediatric Infectious Diseases Society, 11(11), 498-503. https://doi.org/10.1093/jpids/piac080
Nguyen, S. N., Lam T. V., Quang V. V., Tham T. T., & Vi Tuong T. D.. (2022). Clinical Epidemiology Characteristics and Etiology of Febrile Neutropenia in Children: Analysis of 421 Cases. Hematology Reports, 14(3), 245–252. MDPI AG. Retrieved from http://dx.doi.org/10.3390/hematolrep14030034
Basu, S. K., Fernandez, I. D., Fisher, S. G., Asselin, B. L., & Lyman, G. H. (2005). Length of stay and mortality associated with febrile neutropenia among children with cancer. Journal of clinical oncology: official journal of the American Society of Clinical Oncology, 23(31), 7958–7966. https://doi.org/10.1200/JCO.2005.01.6378
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