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cancer and the vent

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By Jason Mann No BS pulmonary critical care fellow
Virginie Lemiale, Matthieu Resche-Rigon, Djamel Mokart, Frederic Pène, Antoine Rabbat, Achille Kouatchet, François Vincent, Fabrice Bruneel, Martine Nyunga, Christine Lebert, Pierre Perez, Anne-Pascale Meert, Dominique Benoit, Sylvie Chevret, Elie Azoulay
BACKGROUND: In patients with hematological malignancies and acute respiratory failure (ARF), noninvasive ventilation was associated with a decreased mortality in older studies. However, mortality of intubated patients decreased in the last years. In this study, we assess outcomes in those patients according to the initial ventilation strategy. METHODS: We performed a post hoc analysis of a prospective multicentre study of critically ill hematology patients, in 17 intensive care units in France and Belgium...
December 2015: Annals of Intensive Care
Rakesh Vadde, Stephen M Pastores
Acute respiratory failure (ARF) is the leading cause of intensive care unit admission in patients with hematologic malignancies and is associated with a high mortality. The main causes of ARF are bacterial and opportunistic pulmonary infections and noninfectious lung disorders. Management consists of a systematic clinical evaluation aimed at identifying the most likely cause, which in turn determines the best first-line empirical treatments. The need for mechanical ventilation is a major determinant of prognosis...
December 2016: Journal of Intensive Care Medicine
V Squadrone, G Ferreyra, V M Ranieri
Immunosuppressed patients are usually considered together without distinction. However, patients with hematologic malignancy should be included in a different subcategory. The outcome of this population has improved over the years. However, mortality rate continues to be high, especially when respiratory complications are present and mechanical ventilation is required. Non-invasive ventilation (NIV) demonstrated its efficacy on the process of respiratory failure improving clinical outcomes in patients of different diagnoses...
October 2015: Minerva Anestesiologica
Elie Azoulay, Virginie Lemiale, Djamel Mokart, Frédéric Pène, Achille Kouatchet, Pierre Perez, François Vincent, Julien Mayaux, Dominique Benoit, Fabrice Bruneel, Anne-Pascale Meert, Martine Nyunga, Antoine Rabbat, Michael Darmon
PURPOSE: Little attention has been given to ARDS in cancer patients, despite their high risk for pulmonary complications. We sought to describe outcomes in cancer patients with ARDS meeting the Berlin definition. METHODS: Data from a cohort of patients admitted to 14 ICUs between 1990 and 2011 were used for a multivariable analysis of risk factors for hospital mortality. RESULTS: Of 1,004 included patients (86 % with hematological malignancies and 14 % with solid tumors), 444 (44...
August 2014: Intensive Care Medicine
Giuseppe R Gristina, Massimo Antonelli, Giorgio Conti, Alessia Ciarlone, Silvia Rogante, Carlotta Rossi, Guido Bertolini
BACKGROUND: Mortality is high among patients with hematologic malignancies admitted to intensive care units for acute respiratory failure. Early noninvasive mechanical ventilation seems to improve outcomes. OBJECTIVE: To characterize noninvasive mechanical ventilation use in Italian intensive care units for acute respiratory failure patients with hematologic malignancies and its impact on outcomes vs. invasive mechanical ventilation. DESIGN, SETTING, PARTICIPANTS: Retrospective analysis of observational data prospectively collected in 2002-2006 on 1,302 patients with hematologic malignancies admitted with acute respiratory failure to 158 Italian intensive care units...
October 2011: Critical Care Medicine
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