Advancing the development of hematology care units to enhance hematology-specific critical care capacity
10.3760/cma.j.cn121090-20250922-00432
- VernacularTitle:推进血液重症监护病房建设，提高血液专科重症救治能力
- Author:
Shengjin FAN
1
;
Haitao LI
;
Xi ZHANG
Author Information
1. 哈尔滨医科大学附属第一医院血液内科重症监护病房，哈尔滨 150001
- Publication Type:Journal Article
- From:
Chinese Journal of Hematology
2025;46(11):985-990
- CountryChina
- Language:Chinese
-
Abstract:
Establishing hematology care units (HCU) is essential for strengthening hematology-specific critical care capacity. This article outlines two HCU operational models in China—the ICU model and the pre-ICU model—and discusses practical insights from their implementation. It recommends establishing HCU within hematology wards, equipped for respiratory and hemodynamic monitoring and blood purification, and led by hematologists trained in critical care or by teams collaborating efficiently with general ICU through standardized workflows. For units not yet meeting these standards, establishing a resuscitation room and strengthening critical care training are advised. HCU primarily admit patients with severe or life-threatening bleeding due to hematologic diseases, severe infections or septic shock, early complications of newly diagnosed acute myeloid leukemia or acute promyelocytic leukemia (AML/APL), treatment-related complications, rapidly progressive or highly lethal conditions, and those requiring organ support or blood purification. Emphasis is placed on quantitative assessment of disease severity and timely transfer to the HCU, using tools such as the National Early Warning Score, quick Sequential Organ Failure Assessment (qSOFA), SOFA/ΔSOFA, and the Multinational Association of Supportive Care in Cancer risk index for patient stratification. Early implementation of sepsis bundles is emphasized. For organ support, high-flow nasal cannula oxygen therapy is prioritized to improve oxygenation. Continuous renal replacement therapy is performed when there are indications such as renal failure with oliguria or anuria, congestive heart failure, or drug overdose, etc. Treatment of the underlying hematologic disease follows a "three-tier stratification" and "watch-and-adjust" strategy, while respecting patient preferences. We encourage eligible hematology centers to actively establish HCU, explore new care models, and strengthen hematology-specific critical care capacity.
