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Mechanical ventilation in cancer patients.
C Saillard1, D Mokart, V Lemiale
1Hematology Department, Institut Paoli Calmettes, Marseille, France - mokartd@ipc.unicancer.fr.
Minerva Anestesiologica
|November 28, 2013
Summary
Acute respiratory failure in cancer patients requires updated management. Early diagnosis and appropriate ventilatory support, including non-invasive ventilation (NIV), improve survival, but NIV failure is detrimental.
Area of Science:
- Critical Care Medicine
- Oncology
- Respiratory Medicine
Background:
- Acute respiratory failure (ARF) is a severe complication in cancer patients, despite overall survival improvements.
- Recent advances in intensive care and cancer treatment have modified ARF outcomes and management.
Purpose of the Study:
- To review updated diagnostic and therapeutic strategies for ARF in cancer patients.
- To summarize recent literature on managing ARF in the context of evolving intensive care and onco-hematologic treatments.
Main Methods:
- Review of recent literature and clinical data on ARF in cancer patients.
- Analysis of diagnostic approaches, including invasive and non-invasive strategies.
- Evaluation of different ventilatory support modalities and their indications.
Main Results:
- Survival for cancer patients needing ICU ventilatory support has improved.
- Non-invasive ventilation (NIV) reduces mortality but failure (requiring invasive mechanical ventilation) is associated with poor outcomes.
- Organ failure count within the first 7 ICU days is a key prognostic factor, superseding classical factors.
Conclusions:
- ARF management in cancer patients necessitates a tailored approach considering updated intensive care and oncology practices.
- Appropriate selection and use of NIV are critical to improve outcomes.
- Prognosis is heavily influenced by the number of organ failures during the initial ICU stay.
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