However, the link between thrombocytopenia and bleeding is unclear in the critically ill hemato-oncological patients where platelet aggregative functions and vascular integrity may also be altered. Therefore, additional studies are required to clarify the indications and thresholds for platelet transfusion in these patients. Granulocyte transfusion has become anecdotal. Antibiotics and antifungals Antibiotic and antifungal therapy is at the core of critical care of cancer patients, but its effectiveness is threatened by increasing resistance and faltering development of new drugs. Multidrug resistance is ubiquitous. Recent updates have included the advice to tailor empirical schemes to local ecology [3, 5], to restrict dual Gram-negative and anti-MRSA empirical coverage to specified patient risk categories [65, 66], and to de-escalate in patients with susceptible pathogens and clinical stabilization [67]. Hematology versus oncology: the main differences While up to 15% of patients with a hematological malignancy will require admission to ICU [7], the majority of ICU cancer patients have solid tumors. One in 20 patients with a solid tumor will require admission to ICU within 2 years of diagnosis [68, 69], and they account for 85–93% of the ICU cancer workload (most are elective postoperative patients) [70]. In contrast, patients with hematological malignancies are more likely to be admitted to the ICU because of a medical condition, with high severity of illness scores and poorer outcomes as a result [8, 71]. Other striking differences include the small number of critically ill patients with solid tumors who are medical (as compared to scheduled surgery), profoundly neutropenic, or present with invasive fungal infection. Similarly, compared to patients with acute leukemia or lymphoma, chemotherapy is rarely given to patients with solid tumors in the ICU. While the demographics may be different, short-term survival in both solid tumor and hematological malignancy patients has been consistently demonstrated to be related to the severity of illness rather than the underlying malignant diagnosis [72]. However, performance of physiologic scores is poor in cancer patients. Instead, severity of organ dysfunction, at admission and throughout the ICU stay, is associated with mortality. A medical emergency team (MET) critical care expertise wherever it is needed to prevent morbidity or mortality. MET activation is indicated when a staff member is worried about a patient. MET implementation is associated with reductions in both hospital mortality and non-ICU cardiopulmonary arrests [73,74,75,76]. Last, studies have shown that in patients undergoing surgical procedures, protective lung ventilation during anesthesia translates into reduced complication rates and decreased ICU admissions. ICU organization Optimization of ICU organization and processes of care is paramount in the face of increasing demands and costs to provide high-quality and affordable critical care to a growing population of patients living with cancer. Improved outcomes were observed in patients transferred from the wards to the ICU early in the course of an acute illness [8, 17, 18, 77] and in those admitted to ICUs run by intensivists [78]. In a recent multicenter study, daily formal meetings between the attending hematologist/oncologist and intensivist for the purpose of care planning and the implementation of protocols were associated with lower mortality rates and more efficient resource use [6]. Mortality was also