Category: Supportive Care
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Central Line Care and Management
A central venous access, or central line (CL), is a device inserted through a vein with the catheter tip positioned in a central vein, typically the superior vena cava or the caval atrial junction. It provides reliable access to the central venous system, and its placement is verified by radiographic studies during and after insertion.…
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Chemotherapeutic Toxicities
Neurotoxicity Ifosfamide Ifosfamide is a nitrogen mustard derivative that acts as a DNA alkylation agent. It is commonly used in solid and hematologic malignancies. Neurotoxicity with ifosfamide is common, occurring in 5-40% of patients, especially with higher doses. Neurotoxicity frequently occurs during the course of treatment and presents as: The onset of symptoms is acute, presenting within…
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Blood Components Transfusion
Over the past two decades, transfusion practices have evolved significantly, especially in terms of enhanced safety protocols to minimize the risk of transfusion-transmitted infections, such as variant Creutzfeldt-Jakob disease (vCJD). Specific safety improvements have also been implemented for neonatal and pediatric blood components. However, it remains crucial to transfuse blood components only when necessary and…
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Management of Electrolytes
The management of fluid and electrolyte imbalances is a crucial aspect of caring for pediatric oncology patients. While certain issues are unique to patients with malignancies, their treatment adheres to the general principles of paediatrics. Causes of electrolyte imbalance Pediatric oncology patients are at high risk of developing fluid balance abnormalities: Hyponatremia Definition Na <…
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Nausea and Vomiting
Nausea and vomiting are well-known side effects of cancer therapy and affect most patients who have chemotherapy. Radiation therapies to the brain, gastrointestinal tract, or liver also cause nausea and vomiting. Nausea is controlled by a part of the autonomic nervous system which controls involuntary body functions (such as breathing or digestion. Vomiting is a reflex controlled in part…
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Specific Infections
In pediatric oncology, managing infections like varicella (chickenpox) and measles is crucial due to the patients’ compromised immune systems. Prevention strategies are paramount and include hygiene measures, isolation protocols, and vaccinations. Treatment is tailored to the specific infection and the patient’s immunological status, often involving antiviral, antibacterial, or antifungal agents, and supportive care. Monitoring for…
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Infection in Immunocompromised Patients
Patients with cancer are at increased risk of infection as a result of their disease and/or its treatment. Febrile neutropenia is a medical emergency requiring urgent investigation and the administration of intravenous empirical antibiotic therapy within 1-2 hours. Aggressive use of inpatient intravenous antibiotic therapy has reduced morbidity and mortality rates and reduced the need for…
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Oral Mucositis
Oral mucositis (OM) occurs in more than 50% of pediatric patients who receive cancer treatment and is one of the most distressing side effects of chemotherapy. Prevention of oral mucositis and subsequently preventing secondary oral infections is the cornerstone of management. In this context, parents and child education is an essential part of management at diagnosis,…