Characteristics and outcomes of cancer patients requiring mechanical ventilatory support for &gt;24 hrs*

Soares, Márcio; Salluh, Jorge I.; Spector, Nelson; Rocco, José Rodolfo

doi:10.1097/01.ccm.0000155783.46747.04

Cited by 158 publications

(94 citation statements)

References 42 publications

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“…These findings are extremely relevant, as treatment decisions are substantially influenced by the clinical condition of the patient. In ICU cancer patients, poor performance status has been associated with mortality [7,17]. Moreover, poor performance status may prevent the use of optimally aggressive chemo-and radiation therapy regimens and/or decrease the ability to achieve radical surgical resection, thereby diminishing long-term survival.…”

mentioning

confidence: 99%

“…Although a fast response would be expected, chemotherapy in the ICU failed to improve outcomes [10], particularly in SCLC patients with extensive disease [20]. Despite the introduction of new treatment strategies, acute respiratory failure secondary to pulmonary involvement or airway obstruction by the malignancy remains associated with very high mortality rates [10,17,20].…”

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confidence: 99%

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Critical care management of lung cancer patients to prolong life without prolonging dying

Soares

Azoulay

2009

Intensive Care Med

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confidence: 99%

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confidence: 99%

Critical care management of lung cancer patients to prolong life without prolonging dying

Soares

Azoulay

2009

Intensive Care Med

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“…It is hypothesized that the reason for this is that, in cases where accompanying VAP or difficult extubation is predicted, past reports (8) have led to the expectation that improvement is more likely to be achieved with NPPV than IMV; thus NPPV was more frequently applied in the ICU treatment group (10). However, the severity of acute respiratory failure as a complication of hematological malignancy makes it difficult to manage acute respiratory failure with mechanical ventilation via NPPV alone (16). Consequently, almost all of the cases progressed to IMV.…”

Section: Discussionmentioning

confidence: 99%

The Therapeutic Outcomes of Mechanical Ventilation in Hematological Malignancy Patients with Respiratory Failure

et al. 2016

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Objective In hematological malignancy patients, the complication of acute respiratory failure often reaches a degree of severity that necessitates mechanical ventilation. The objective of the present study was to investigate the therapeutic outcomes of mechanical ventilation in hematological malignancy patients with respiratory failure and to analyze the factors that are associated with successful treatment in order to identify the issues that should be addressed in the future. Methods The present study was a retrospective analysis of 71 hematological malignancy patients with noncardiogenic acute respiratory failure who were treated with mechanical ventilation at Nippon Medical School Hospital between 2003 and 2014. Results Twenty-six patients (36.6%) were treated with mechanical ventilation in an intensive care unit (ICU). Non-invasive positive pressure ventilation (NPPV) was applied in 29 cases (40.8%). The rate of successful mechanical ventilation treatment with NPPV alone was 13.8%. The rate of endotracheal extubation was 17.7%. A univariate analysis revealed that the following factors were associated with the successful extubation of patients who received invasive mechanical ventilation: respiratory management in an ICU (p= 0.012); remission of the hematological disease (p=0.011); female gender (p=0.048); low levels of accompanying non-respiratory organ failure (p=0.041); and the non-use of extracorporeal circulation (p=0.005). A subsequent multivariate analysis revealed that respiratory management in an ICU was the only variable associated with successful extubation (p=0.030). Conclusion The outcomes of hematological malignancy patients who receive mechanical ventilation treatment for respiratory failure are very poor. Respiratory management in an ICU environment may be useful in improving the therapeutic outcomes of such patients.

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“…The high mortality of more than 80% in patients requiring mechanical ventilation (Table 1) [8][9][10][11][12][13][14][15] , increasing to more than 90% to 95% in patients developing multiple organ failure or who require renal replacement therapy during ICU stay 12,[16][17][18] , particularly in the transplant setting [19][20][21] , together with the severe emotional burden endured by these patients and their relatives, and the considerable costs of advanced and prolonged life-supporting therapy 13 resulted in a general reluctance to admit such patients to the ICU 2,6,7 . However, over the past few years, several centres throughout the world have been reporting on increasingly improving survival in critically ill patients with hematological malignancies and solid tumors [22][23][24][25][26][27][28][29][30][31] , approaching survival rates reported in general ICU patients 32 . In a case-historical control study 22 , Azoulay et al reported a four-fold lower risk of death in cancer patients who required mechanical ventilation between 1996 and 1998 as compared with 1990-1995.…”

Section: Outcome In Critically Ill Cancer Patients: Evolution Over Thmentioning

confidence: 99%

Outcome in critically ill cancer patients: past and present

Benoît¹,

Depuydt²

2008

Rev. bras. ter. intensiva

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RESUMO JUSTIFICATIVA E OBJETIVOS: Até o final do século passado, havia grande incerteza quanto a propriedade de internar pacientes com câncer em unidades de terapia intensiva (UTI) para medidas de suporte avançado. Contudo, ao longo dos últimos anos, vários centros ao redor do mundo têm reportado aumento significativo da sobrevida de tais pacientes. O objetivo deste estudo foi rever os principais artigos publicados nas duas últimas décadas, com foco na melhoria do prognóstico de pacientes com câncer criticamente enfermos. CONTEÚDO: Realizou-se uma busca bibliográfica no sistema MedLine -PubMed (www.pubmed.gov) para identificar artigos em linguagem inglesa sobre cuidados intensivos no pacientes com tumores sólidos ou neoplasias hematológicas, com ênfase no prognóstico e no tratamento. Utilizaram-se os seguintes unitermos: cancer, solid tumor, hematologic or hematological malignancies, immunosupression, ICU, ventilation, organ failure, sepsis and infection. Estudos referenciados nos artigos selecionados na busca também foram utilizados. CONCLUSÕES: O tema será abordado de forma sistematizada. Inicialmente, haverá uma discussão sobre o prognóstico sombrio experimentado por estes pa-

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Characteristics and outcomes of cancer patients requiring mechanical ventilatory support for >24 hrs*

Abstract: Severity of acute organ failures, poor performance status, cancer status, and older age were the main determinants of mortality. The appropriate use of such easily available clinical characteristics may avoid forgoing intensive care for patients with a chance of survival.

Cited by 158 publications

References 42 publications

Critical care management of lung cancer patients to prolong life without prolonging dying

Critical care management of lung cancer patients to prolong life without prolonging dying

The Therapeutic Outcomes of Mechanical Ventilation in Hematological Malignancy Patients with Respiratory Failure

Outcome in critically ill cancer patients: past and present

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