PURPOSE: The objective was to describe the characteristics and outcomes of critically ill cancer patients who received noninvasive positive pressure ventilation (NIPPV) vs invasive mechanical ventilation as first-line therapy for acute hypoxemic respiratory failure. MATERIAL AND METHODS: A retrospective cohort study of consecutive adult intensive care unit (ICU) cancer patients who received either conventional invasive mechanical ventilation or NIPPV as first-line therapy for hypoxemic respiratory failure. RESULTS: Of the 1614 patients included, the NIPPV failure group had the greatest hospital length of stay, ICU length of stay, ICU mortality (71.3%), and hospital mortality (79.5%) as compared with the other 2 groups (P < .0001). The variables independently associated with NIPPV failure included younger age (odds ratio [OR], 0.99; 95% confidence interval [CI], 0.98-0.99; P=.031), non-Caucasian race (OR, 1.61; 95% CI, 1.14-2.26; P=.006), presence of a hematologic malignancy (OR, 1.87; 95% CI, 1.33-2.64; P=.0003), and a higher Sequential Organ Failure Assessment score (OR, 1.12; 95% CI, 1.08-1.17; P < .0001). There was no difference in mortality when comparing early vs late intubation (less than or greater than 24 or 48 hours) for the NIPPV failure group. CONCLUSION: Noninvasive positive pressure ventilation failure is an independent risk factor for ICU mortality, but NIPPV patients who avoided intubation had the best outcomes compared with the other groups. Early vs late intubation did not have a significant impact on outcomes.
PURPOSE: The objective was to describe the characteristics and outcomes of critically ill cancerpatients who received noninvasive positive pressure ventilation (NIPPV) vs invasive mechanical ventilation as first-line therapy for acute hypoxemic respiratory failure. MATERIAL AND METHODS: A retrospective cohort study of consecutive adult intensive care unit (ICU) cancerpatients who received either conventional invasive mechanical ventilation or NIPPV as first-line therapy for hypoxemic respiratory failure. RESULTS: Of the 1614 patients included, the NIPPV failure group had the greatest hospital length of stay, ICU length of stay, ICU mortality (71.3%), and hospital mortality (79.5%) as compared with the other 2 groups (P < .0001). The variables independently associated with NIPPV failure included younger age (odds ratio [OR], 0.99; 95% confidence interval [CI], 0.98-0.99; P=.031), non-Caucasian race (OR, 1.61; 95% CI, 1.14-2.26; P=.006), presence of a hematologic malignancy (OR, 1.87; 95% CI, 1.33-2.64; P=.0003), and a higher Sequential Organ Failure Assessment score (OR, 1.12; 95% CI, 1.08-1.17; P < .0001). There was no difference in mortality when comparing early vs late intubation (less than or greater than 24 or 48 hours) for the NIPPV failure group. CONCLUSION: Noninvasive positive pressure ventilation failure is an independent risk factor for ICU mortality, but NIPPVpatients who avoided intubation had the best outcomes compared with the other groups. Early vs late intubation did not have a significant impact on outcomes.
Authors: Cristina Gutierrez; Anne Rain T Brown; Megan M Herr; Sameer S Kadri; Brian Hill; Prabalini Rajendram; Abhijit Duggal; Cameron J Turtle; Kevin Patel; Yi Lin; Heather P May; Alice Gallo de Moraes; Marcela V Maus; Mathew J Frigault; Jennifer N Brudno; Janhavi Athale; Nirali N Shah; James N Kochenderfer; Ananda Dharshan; Amer Beitinjaneh; Alejandro S Arias; Colleen McEvoy; Elena Mead; R Scott Stephens; Joseph L Nates; Sattva S Neelapu; Stephen M Pastores Journal: J Crit Care Date: 2020-04-15 Impact factor: 3.425
Authors: Hasan M Al-Dorzi; Haya Al Orainni; Faten Al Eid; Haytham Tlayjeh; Abedalrahman Itani; Ayman Al Hejazi; Yaseen M Arabi Journal: Ann Thorac Med Date: 2017 Oct-Dec Impact factor: 2.219