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. 2009;13(6):R173.
doi: 10.1186/cc8149. Epub 2009 Nov 3.

Risk factors for acute respiratory distress syndrome during neutropenia recovery in patients with hematologic malignancies

Chin Kook Rhee  1 , Ji Young Kang, Yong Hyun Kim, Jin Woo Kim, Hyung Kyu Yoon, Seok Chan Kim, Soon Suk Kwon, Young Kyoon Kim, Kwan Hyung Kim, Hwa Sik Moon, Sung Hak Park, Hee Je Kim, Seok Lee, Jeong Sup Song
Affiliations

Risk factors for acute respiratory distress syndrome during neutropenia recovery in patients with hematologic malignancies

Chin Kook Rhee et al. Crit Care. 2009.

Abstract

Introduction: Neutropenia recovery may be associated with deterioration in oxygenation and exacerbation of pre-existing pulmonary disease. However, risk factors for acute respiratory distress syndrome (ARDS) during neutropenia recovery in patients with hematologic malignancies have not been studied.

Methods: We studied critically ill patients with hematologic malignancies with the dual objectives of describing patients with ARDS during neutropenia recovery and identifying risk factors for ARDS during neutropenia recovery. A cohort of consecutive neutropenic patients with hematologic malignancies who were admitted to the intensive care unit (ICU) was studied. During a 6-year period, 71 patients recovered from neutropenia, of whom 38 (53.5%) developed ARDS during recovery.

Results: Compared with non-ARDS patients, patients who experienced ARDS during neutropenia recovery were more likely to have pneumonia, be admitted to the ICU for respiratory failure, and receive mechanical ventilator therapy. The in-ICU mortality was significantly different between the two groups (86.8% versus 51.5%, respectively, for patients who developed ARDS during neutropenia recovery versus those who did not during neutropenia recovery). In multivariate analysis, only occurrence of pneumonia during the neutropenic episode was associated with a marked increase in the risk of ARDS (odds ratio, 4.76).

Conclusions: Patients with hematologic malignancies complicated by pneumonia during neutropenia are at increased risk for ARDS during neutropenia recovery.

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Figures

Figure 1
Figure 1
Study subjects. ARDS = acute respiratory distress syndrome; ICU = intensive care unit, HSCT = hematopoietic stem cell transplantation.
Figure 2
Figure 2
Number of patients who survived or died during intensive care unit stay. ARDS = acute respiratory distress syndrome; NR = neutropenia recovery.
Figure 3
Figure 3
Number of patients according to underlying disease. ABL = acute biphenotypic leukemia; AML = acute myeloid leukemia; ALL = acute lymphoblastic leukemia; ARDS = acute respiratory distress syndrome; CML = chronic myeloid leukemia; Lymp = lymphoma; MM = multiple myeloma; NR = neutropenia recovery.
See this image and copyright information in PMC

References

    1. Benoit DD, Vandewoude KH, Decruyenaere JM, Hoste EA, Colardyn FA. Outcome and early prognostic indicators in patients with a hematologic malignancy admitted to the intensive care unit for a life-threatening complication. Crit Care Med. 2003;31:104–112. doi: 10.1097/00003246-200301000-00017. - DOI - PubMed
    1. Sculier JP, Markiewicz E. Medical cancer patients and intensive care. Anticancer Res. 1991;11:2171–2174. - PubMed
    1. Azoulay E, Recher C, Alberti C, Soufir L, Leleu G, Le Gall JR, Fermand JP, Schlemmer B. Changing use of intensive care for hematological patients: the example of multiple myeloma. Intensive Care Med. 1999;25:1395–1401. doi: 10.1007/s001340051087. - DOI - PubMed
    1. Rinaldo JE, Borovetz H. Deterioration of oxygenation and abnormal lung microvascular permeability during resolution of leukopenia in patients with diffuse lung injury. Am Rev Respir Dis. 1985;131:579–583. - PubMed
    1. Azoulay E, Darmon M, Delclaux C, Fieux F, Bornstain C, Moreau D, Attalah H, Le Gall JR, Schlemmer B. Deterioration of previous acute lung injury during neutropenia recovery. Crit Care Med. 2002;30:781–786. doi: 10.1097/00003246-200204000-00010. - DOI - PubMed

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