Critical Care of Hematopoietic Stem Cell Transplant Patients

Abstract

Life-threatening complications are frequent after hematopoietic stem cell transplant (HSCT), and optimum critical care is essential to ensuring good outcomes. The immunologic consequences of HSCT result in a markedly different host response to critical illness. Infection is the most common cause of critical illness but noninfectious complications are frequent. Respiratory failure or sepsis are the typical presentations but the sequelae of HSCT can affect nearly any organ system. Pattern recognition can facilitate anticipation and early intervention in post-HSCT critical illness. HSCT critical care is a multidisciplinary endeavor. Continued investigation and focus on process improvement will continue to improve outcomes.

Keywords: Acute renal failure; Acute respiratory distress syndrome; Bone marrow transplant; Cytokine release syndrome; Engraftment syndrome; Graft-versus-host disease; Hematopoietic stem cell transplant; Neutropenic sepsis.