Prognostic factors of noninvasive mechanical ventilation in lung cancer patients with acute respiratory failure

Abstract

IntroductionFew studies have reported outcomes of lung cancer patients with acute respiratory failure (RF) using noninvasive positive pressure ventilation (NIPPV). The aim of this study was to investigate the prognostic factors in these patients.Materials and methodsThis retrospective observational study included all hospitalized lung cancer patients who received NIPPV for acute RF. It was conducted at a tertiary medical center in Taiwan from 2005 to 2010. The primary outcome was all cause mortality at 28 days after the initiation of NIPPV. Secondary outcomes included all-cause in-hospital mortality, weaning from NIPPV, intubation rate, tracheostomy rate, duration of NIPPV, hospital stay and intensive care unit stay.ResultsThe all-cause mortality rate at day 28 of the enrolled 58 patients was 39.66%. The 90-day and 1-year mortality rates were 63.79% and 86.21%, respectively. NIPPV as the first line therapy for RF had higher 28-day mortality rate than it used for post-extubation RF (57.6% versus 16.0%, p<0.05). Independent predictors of mortality at 28 days were progressive disease or newly diagnosed lung cancer (OR 14.02 95% CI 1.03–191.59, p = 0.048), combined with other organ failure (OR 18.07 95% CI 1.87–172.7, p = 0.012), and NIPPV as the first line therapy for RF (OR 35.37 95% CI 3.30–378.68, p = 0.003).ConclusionLung cancer patients using NIPPV with progressive or newly diagnosed cancer disease, combined with other organ failure, or NIPPV as the first line therapy for respiratory failure have a poor outcome.

The success of non‐invasive mechanical ventilation in lung cancer patients with respiratory failure

“…previous study reported that a positive culture was associated with a poor prognosis for patients in the ICU, 14 and although results were not statistically significant, a positive culture negatively affected NIMV success in the present study.…”

“…13 Another study reported a high rate of mortality with NIMV treatment for respiratory failure in patients with recently diagnosed lung cancer, or in those with progressive disease and organ failure. 14 Studies investigating the success of NIMV in patients with lung cancer are limited, and to the best of our knowledge, no previous study has investigated the success of NIMV in a hospital ward setting. In the present study, we investigate retrospectively the success of NIMV among patients with lung cancer (including all stages and histopathological types) in a hospital ward setting, and detail the factors affecting its success.…”

Implications of intensive care unit admissions among medicare beneficiaries following resection of pancreatic cancer

“…Of note, the need for ventilatory support was strongly associated with in‐hospital mortality among patients with pancreatic cancer admitted to the ICU. Noninvasive and invasive ventilatory support have both been associated with high morbidity and mortality in patients with cancer admitted to an ICU 11,39,40 . While acute respiratory failure may be a common reason for ICU admission among medical patients, only a very small proportion (2.1%) of patients with pancreatic cancer required mechanical ventilation.…”

Acute and Chronic Respiratory Failure in Cancer Patients

“…Failure rates of NIV in the cancer patient vary widely from 25% up to 70% [14,45,161]. Unfortunately, data consistently indicate that outcomes are far worse following failure of NIV [41,122,181].…”