Overview

The cancer patient in your ICU is deteriorating on hour three, the team is waiting, and nothing in your general critical care training prepared you for this exact intersection of refractory haematological malignancy, calcineurin inhibitor toxicity, and a fever that could be GVHD, CMV, or sepsis - simultaneously. General ICU protocols applied to the oncological patient produce oxygen targets that accelerate bleomycin fibrosis, analgesic regimens that send opioid-tolerant patients into withdrawal, and platelet transfusions that kill the patient with TTP. This book builds the clinical reasoning framework that transforms oncological critical care from educated guesswork into mechanistic precision - at the bedside, in real time, with the patient in front of you. Inside this book: - Tocilizumab versus dexamethasone - understand exactly why these are never interchangeable and which one you reach for when CRS and ICANS coexist in the same post-CAR-T patient - Methylene blue as a specific antidote - diagnose ifosfamide encephalopathy and reverse it within hours instead of sedating your way through a treatable toxidrome - The oxygen amplification trap - apply the 92-94% SpO2 ceiling that prevents bleomycin toxicity from becoming fulminant respiratory failure under your care - Post-transplant day-by-day - use the phased immune reconstitution timeline to narrow the infectious differential the moment you know how many days it has been since infusion - APL coagulopathy in real time - initiate ATRA on morphological suspicion alone, prioritise cryoprecipitate over FFP, and manage differentiation syndrome before it becomes respiratory failure - REMAP in the family meeting room - deliver honest prognosis, surface the patient's values, and make a recommendation that gives families a path forward rather than an impossible decision This book is for intensivists, haematology-oncology fellows, oncology nurses, advanced practice providers, and any clinician who manages critically ill cancer patients and refuses to treat them as general ICU patients who happen to have cancer. Add it to your cart and give every oncological patient you care for the precision they deserve.

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