Escudo de la República de Colombia

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Infections increase death of children with cancer

Bacteria in blood, malnutrition or stunted growth (height-for-age) have a bearing on the death rate of children which are admitted to intensive care units.

Bogotá D. C., 16 de marzo de 2016Agencia de Noticias UN-

Most children admitted to the PICU had acute lymphocytic leukemia (ALL). Photo: UNal Archives

Almost all children were malnourished or had stunted growth (height-for-age). Photo: UNal Archives

Although progress has been achieved in cancer treatment, complications due to the disease are increasing. Photo: UNal Archives

The research project was carried out at the main PICU in Colombia which only cares for children with cancer diagnosis. Photo: UNal Archives

Breathing issues were the main cause of death in patients. Photo: UNal Archives

Blood infections were also a cause of death. Photo: UNal Archives

Universidad Nacional de Colombia (UNal) Pediatric Intensive Care Specialists Mónica Arias recorded the admittance conditions and death rate of children with cancer admitted to the National Cancer Institute’s Pediatric Intensive Care Unit (PICU). Children arrive to the institute from all parts of the country. 

In total she assessed 201 cancer patients. Girls were slightly the majority with 53.2% (109), while boys represented 45.7% (92). Furthermore 22.4% of the children suffered from acute lymphocytic leukemia, 14.4% from tumors in the central nervous system and 7.9% from bone tumors. 

The research project which was carried out during one year and nine months recorded a death rate of 12.2%, demonstrating that infections represented one of the main causes of death. 

Additionally a nutritional diagnosis showed that 12.9% of the children had acute malnutrition and 23.4% had stunted growth. This also had an impact on the mortality as when children are malnourished infections are often more severe. 

Infections to the central nervous system, pulmonary bleeding, acute respiratory failure and cardiac tamponade were also recorded as causes of death. 

“We demonstrated that children which were admitted to the PICU without infection had less risk of dying. On the other hand, those with infections had less likelihood of surviving,” said UNal Faculty of Medicine Professor and Research Project Co-Director Dr. Pablo Vásquez. 

Multiple organ dysfunction failure was also recorded as a frequent cause of death in children. 

The most frequent cause of admittance was for medical causes in 67.4% of the cases. Furthermore most children who had leukemia were admitted to the ICU for blood infections (bacteremia). 

“Treatment to fight leukemia leave the patient defenseless and bacteria take advantage and attack the blood,” said Vásquez. 

According to Arias, survival of children with cancer has increased as diagnostic and therapeutic methods have also improved. However as this occurs, complications due to the disease increase. 

“Before a patient with cancer would die. But not today, but we are beginning to see that they have complications as a cause of this disease; for instance the probability of having severe infections, metabolic alterations or respiratory or cardiovascular failure increases,” she said. 

Vásquez added that children with cancer are different than children that are admitted to the PICU for different reasons other than cancer. “Children with cancer do not have working immune systems therefore tests, diagnosis and treatment to infections are dissimilar but determining for the outcome,” he said. 

“Extensive studies on this population are scarce, therefore it is necessary to continue to record its particular characteristics with the purpose of recognizing signs of infection severity, make use of available resources and technology and continue to save lives,” said Dr. Arias. 

(Por: Fin/VC/MLA/JAAH
)
N.° 309

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