Non-invasive mechanical ventilation in hematology patients: let's agree on several things first
نویسندگان
چکیده
Acute respiratory failure is a dreaded and life-threatening event that represents the main reason for ICU admission. Respiratory events occur in up to 50% of hematology patients, including one-half of those admitted to the ICU. Mortality from acute respiratory failure in hematology patients depends on the patient's general status, acute respiratory failure etiology, need for mechanical ventilation and associated organ dysfunction. Non-invasive mechanical ventilation is clearly beneficial for chronic obstructive pulmonary disease exacerbation and cardiogenic pulmonary edema. These benefits are based mainly on the avoidance of invasive mechanical ventilation complications. Non-invasive mechanical has also been recommended in hematology patients with acute respiratory failure but its real benefits remain unclear in these settings. There is growing concern about the safety of non-invasive mechanical ventilation to treat hypoxemic acute respiratory failure overall, but also in hematology patients. Prophylactic non-invasive mechanical ventilation in patients with acute respiratory failure but not respiratory distress seems to be effective in hematology patients with a reduced rate of intubation. However, curative non-invasive mechanical ventilation should be restricted to those patients with isolated respiratory failure, with fast improvement of respiratory distress under non-invasive mechanical ventilation, and with rapid switch to intubation to avoid deleterious delays in optimal invasive mechanical ventilation.
منابع مشابه
Invasive and Non-invasive Mechanical Ventilation in Pediatric Patients with COVID-19: A Systematic Review
Background and purpose: In the last months of 2019, the new coronavirus infection (COVID-19) spread worldwide. This study investigated the need for mechanical ventilation in children who were admitted for COVID-19. Materials and methods: This article provides a systematic review of studies about children with COVID-19 requiring invasive or non-invasive mechanical ventilation. Electronic databa...
متن کاملThe Effects of Music Therapy on Respiratory Comfort, Anxiety, and Depression During Non-Invasive Mechanical Ventilation Among Patients with Coronavirus Disease
Background: Hospitalized patients with Covid-19 may experience emotional problems and respiratory discomfort during mechanical ventilation. The aim of this study was to evaluate the effects of music therapy on respiratory comfort, anxiety, and depression among patients with Covid-19 under non-invasive mechanical ventilation. Methods: It was a randomized clinical trial. The subjects were 64 pat...
متن کاملVentilatory support in critically ill hematology patients with respiratory failure
INTRODUCTION Hematology patients admitted to the ICU frequently experience respiratory failure and require mechanical ventilation. Noninvasive mechanical ventilation (NIMV) may decrease the risk of intubation, but NIMV failure poses its own risks. METHODS To establish the impact of ventilatory management and NIMV failure on outcome, data from a prospective, multicenter, observational study we...
متن کاملIdentifying cancer subjects with acute respiratory failure at high risk for intubation and mechanical ventilation.
BACKGROUND We sought to identify risk factors for mechanical ventilation in patients with malignancies and acute respiratory failure (ARF). METHODS We analyzed data from a previous randomized controlled trial in which nonintubated oncology and hematology subjects with ARF were randomized to early bronchoalveolar lavage or routine care in 16 ICUs in France. Consecutive patients with malignanci...
متن کاملIdentifying Cancer Patients With Acute Respiratory Failure at High Risk for Intubation and Mechanical Ventilation
BACKGROUND: We sought to identify risk factors for mechanical ventilation in patients with malignancies and acute respiratory failure (ARF). METHODS: We analyzed data from a previous randomized controlled trial in which nonintubated oncology and hematology subjects with ARF were randomized to early bronchoalveolar lavage or routine care in 16 ICUs in France. Consecutive patients with malignanci...
متن کامل