Kafukufuku Watsopano Wokhudza Kuopsa kwa Septic Shock mwa Odwala Khansa Yamagazi

Kafukufuku watsopano mu Januware 2022 wa JNCCN-Journal of the National Comprehensive Cancer Network adawunika momwe septic shock pa anthu omwe ali ndi matenda a hematologic, adapeza kuti 67.8% adamwalira m'masiku osakwana 28 ndipo 19.4% yokha idakhalabe ndi moyo patatha masiku 90. Ofufuzawa adaphunzira odwala 459 akuluakulu a khansa ya m'magazi omwe adagonekedwa m'chipatala chifukwa cha septic shock pakati pa Epulo 1, 2016 ndi Marichi 31, 2019. Kafukufukuyu akuwonetsa chiopsezo chachikulu cha gulu la odwalawa poyerekeza ndi odwala omwe alibe khansa, omwe chiwopsezo cha kufa kwa sepsis chakhala chikutsika zaka 20 zapitazi.              

"Zotsatira zathu zikuwonetsa mwayi wodziwitsa anthu za kupha kwa septic shock pakati pa odwala khansa komanso momwe kulili kofunika kuti tipewe," adatero wofufuza wamkulu Joseph L. Nates, MD, MBA, CMQ, MCCM, Dipatimenti Yosamalira Odwala, The Yunivesite ya Texas MD Anderson Cancer Center. "Tiyenera kupanga njira zodzitetezera kuti tichepetse kuchuluka kwa matenda kwa odwala omwe ali ndi khansa ya m'magazi ndikulimbikitsa kuzindikira msanga kwa sepsis isanapitirire kugwedezeka kwa septic. Tiyeneranso kutsindika kuyambika koyambirira kwa mankhwala opha maantibayotiki, njira zoyenera zowunikira, komanso kutsitsimula kwamadzimadzi kwa odwala omwe ali ndi khansa omwe akuwaganizira kuti ali ndi matenda. ”

Malinga ndi zomwe apeza, kupuma movutikira, kuchuluka kwa lactate m'magazi, komanso kulephera kwa ziwalo zambiri kumawonjezera mwayi wakufa. Nditalandira mankhwala opha maantibayotiki a aminoglycoside kapena chithandizo chokhala ndi cell cell colony stimulator factor kumapangitsa mwayi wopulumuka septic shock episode. Odwala omwe anali ndi allogeneic stem cell transplant ndi matenda ophatikizika ndi omwe adakhala nawo anali ndi moyo wotsikitsitsa wa masiku 90 okha 4%.

"Kafukufukuyu akuwonetsa kuti ngakhale kupita patsogolo pakuzindikiritsa ndi kuchiza odwala omwe ali ndi sepsis, zotsatira zake zimakhalabe zotsika kwambiri kwa odwala omwe ali ndi vuto la hematologic," adatero Sankar Swaminathan, MD, Don Merrill Rees Wapampando Wapampando Wapampando Wapampando Wapadziko Lonse wa Matenda Opatsirana, dipatimenti ya Zamankhwala. , Huntsman Cancer Center-University of Utah Health, yemwe sanachite nawo kafukufukuyu. "Imfa zochulukira kwambiri za odwala otere omwe adavomerezedwa ndi septic shock ndizovuta kwambiri ndipo zikugogomezera kufunika kowongolera njira zodziwira odwala matendawa atangoyamba kumene. Ngakhale kuti Malangizo a NCCN pa Kupewa ndi Kuchiza Matenda Okhudzana ndi Khansa amagwiritsa ntchito njira zochepetsera chiopsezo kuti atsogolere kasamalidwe, kufufuza kwina m'derali ndikofunikira. "

Dr. Swaminathan, yemwe ndi Wachiwiri kwa Wapampando wa NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Panel for Prevention and Treatment of Cancer-Related Infections anapitiriza kuti: "Phunziroli limatchulanso mbali za chithandizo zomwe zingakhale zofunika kwambiri pakuwongolera zotulukapo mu kugwedezeka kwa septic mwa anthuwa, monga kugwiritsa ntchito kale mankhwala opha maantibayotiki, ma cytokines, ndi kuvomerezedwa ku ICU. Ndikuyembekeza kufufuza kwina m'derali komwe kumathandizira kuzindikira komanso kuchiza odwala omwe ali ndi vuto la hematologic omwe ali pachiwopsezo cha septic shock. ”