Outcome From Mechanical Ventilation After Autologous Peripheral Blood Stem Cell Transplantation

Khassawneh, Basheer; White, Peter; Anaissie, Elias; Barlogie, Barthel; Hiller, F. Charles

doi:10.1378/chest.121.1.185

Cited by 130 publications

(87 citation statements)

References 19 publications

(31 reference statements)

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“…In our review, 20% of ventilated patients lived more than 60 days from bronchoscopy in comparison to 43% in non-intubated patientsthis supports other published reports that only autograft recipients intubated for uncomplicated lung injury 24 and allograft recipients intubated at the time of engraftment 25 should be expected to survive to hospital discharge. Rano et al 23 showed that a delay greater than 5 days in the identification of the cause of the pulmonary infiltrates increased the risk of death threefold, but we found that survival was not statistically different after a diagnostic or non-diagnostic bronchoscopy; this difference may be accounted for by our focus on only HSCT patients.…”

Section: Discussionsupporting

confidence: 88%

Retrospective utility of bronchoscopy after hematopoietic stem cell transplant

Hofmeister

Czerlanis

Forsythe

et al. 2006

Bone Marrow Transplant

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Section: Discussionsupporting

confidence: 88%

Retrospective utility of bronchoscopy after hematopoietic stem cell transplant

Hofmeister

Czerlanis

Forsythe

et al. 2006

Bone Marrow Transplant

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“…Recent literature highlights a trend toward lower admission rates for AHCT patients to the ICU. 16 Specifically, Khassawneh et al, 9 in the largest study examining a single homogeneous AHCT cohort, focused on the number of patients requiring MV for supportive care during their transplant period. This study quotes a 6% rate of MV in 1301 patients, compared with 2% in our study.…”

Section: Discussionmentioning

confidence: 99%

“…8 Despite the increased tolerability of an autologous compared with an allogeneic HSCT, ICU admission may represent a significant adverse event, although only a small body of literature exists to help guide clinicians as to which patients benefit from intensive care. [9][10][11][12][13] In this study, we describe the outcome of AHCT recipients transferred to the ICU and identify factors associated with mortality.…”

Section: Introductionmentioning

confidence: 99%

Predictors of mortality in patients undergoing autologous hematopoietic cell transplantation admitted to the intensive care unit

Trinkaus

Lapinsky

Crump

et al. 2008

Bone Marrow Transplant

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patients received autologous hematopoietic cell transplants (AHCT) at Canada's largest transplant center. In this retrospective cohort study of AHCT patients admitted to the intensive care unit (ICU), we describe the outcomes following ICU admission and the variables measured in the first 24 h of ICU admission associated with overall ICU mortality. Results indicate a 3.3% ICU admission rate (n ¼ 34) with 13 deaths (1% overall mortality rate, 38% in ICU mortality rate). The worst outcome was in AL amyloid patients of whom 28% were admitted to the ICU, with an ICU mortality rate of 55%. The Sequential Organ Failure Assessment (SOFA) score and Acute Physiology and Chronic Health Evaluation (APACHE II) score in the first 24 h were statistically associated with mortality by univariate analysis. Other variables measured at 24 h and associated with ICU mortality included multiorgan failure, mechanical ventilation, inotropic support 44 h and Gram-negative sepsis. Our data indicate that ICU admission in the autotransplant population is rare and that it is influenced by underlying diagnosis, with AL amyloid patients having the highest risk. Our observations may assist clinical decision-making regarding the continuation of intensive care delivered 24 h after ICU admission.

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“…These improvements come at the cost of an escalating number of patients who experience cancer-related complications and/or treatment-related adverse events 3 and thus need specialized intensive care. Fortunately, since the 1980s, the mortality rate of critically ill cancer patients admitted to the ICU has decreased, 4 including mortality among those who are recipients of hematopoietic stem cell transplants 5 and those who require life-sustaining therapies for the management of acute respiratory failure, [6][7][8] acute renal failure, 9 or septic shock. 10,11 This decrease in mortality has been attributed to a better understanding of the pathophysiology of certain cancer-related complications and the development of effective targeted treatments (eg, rasburicase for tumor lysis syndrome 12 ).…”

mentioning

confidence: 99%