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Outcome: Prognosis Determinants

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Mechanical Ventilation in Critically Ill Cancer Patients

Abstract

Since ventilator support is considered to be a life-sustaining method, and since the aim of palliative care is to improve quality of life, cancer patients requiring ventilation support usually face the dilemma of advance directive. For better palliative care decision, indications for ventilatory support may include the need to mitigate dyspnea, decrease opiate dosages, or prolong time in order to ensure the desire for continued family communication. To understand palliative care and fulfill the patient’s desire, given outcomes and predictors may help patients and their families make decisions about ventilator support in various types of situations; therefore, the aim of this chapter is to review the predictive factors and proposed scores associated with mortality when mechanical support is needed in critical-care cancer patients, as well the predictors of mortality or ventilator support failure in “do-not-intubate” patients who prefer comfort measures only, and hence alternative ventilator support over invasive mechanical ventilation.

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References

  1. Moons Karel GM, Royston P, Vergouwe Y, Grobbee DE, Altman DG. Prognosis and prognostic research: what, why, and how? BMJ. 2009;338:b375.

    Article  CAS  PubMed  Google Scholar 

  2. World Health Organization: WHO Definition of Palliative Care (2011) http://www.who.int/cancer/palliative/definition/en/

  3. Curtis JR, Cook DJ, Sinuff T, White DB, Hill N, Keenan P, et al. Noninvasive positive pressure ventilation in critical and palliative care settings: understanding the goals of therapy. Crit Care Med. 2007;35:932–9.

    Article  PubMed  Google Scholar 

  4. Hawari FI, Nazer LH, Addassi A, Rimawi D, Jamal K. Predictors of ICU admission in patients with cancer and the related characteristics and outcomes: a 5-year registry-based study. Crit Care Med. 2016;44:548–53.

    Article  PubMed  Google Scholar 

  5. Lee DS, Suh GY, Ryu JA, Chung CR, Yang JH, Park CM, Jeon K. Effect of early intervention on long-term outcomes of critically ill cancer patients admitted to ICUs. Crit Care Med. 2015;43:1439–43.

    Article  CAS  PubMed  Google Scholar 

  6. Groeger JS, Lemeshow S, Price K, Nierman DM, Glassman J, Shi W, et al. Multicenter outcome study of cancer patients admitted to the intensive care unit: a probability of mortality model. J Clin Oncol. 1998;17:991–7.

    Article  Google Scholar 

  7. Kress JP, Christenson J, Pohlman AS, Linkin DR, Hall JB. Outcomes of critically ill cancer patients in a university hospital setting. Am J Respir Crit Care Med. 1999;160:1957–61.

    Article  CAS  PubMed  Google Scholar 

  8. Maschmeyer G, Bertschat FL, Moesta KT, Häusler E, Held TK, Nolte M, et al. Outcome analysis of 189 consecutive cancer patients referred to the intensive care unit as emergencies during a 2-year period. Eur J Cancer. 2003;39(6):783–92.

    Article  CAS  PubMed  Google Scholar 

  9. Soares M, Salluh JI, Ferreira CG, Luiz RR, Spector N, Rocco JR. Impact of two different comorbidity measures on the 6-month mortality of critically ill cancer patients. Intensive Care Med. 2005;31(3):408–15.

    Article  PubMed  Google Scholar 

  10. Soares M, Salluh JI. Validation of the SAPS 3 admission prognostic model in patients with cancer in need of intensive care. Intensive Care Med. 2006;32(11):1839–44.

    Article  PubMed  Google Scholar 

  11. Staudinger T, Stoiser B, Müllner M, Locker GJ, Laczika K, Knapp S, et al. Outcome and prognostic factors in critically ill cancer patients admitted to the intensive care unit. Crit Care Med. 2000;28(5):1322–8.

    Article  CAS  PubMed  Google Scholar 

  12. Taccone FS, Artigas AA, Sprung CL, Moreno R, Sakr Y, Vincent JL. Characteristics and outcomes of cancer patients in European ICUs. Crit Care. 2009;13(1):R15.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Peigne V, Rusinová K, Karlin L, Darmon M, Fermand JP, Schlemmer B, Azoulay E. Continued survival gains in recent years among critically ill myeloma patients. Intensive Care Med. 2009;35(3):512–8.

    Article  PubMed  Google Scholar 

  14. Chaoui D, Legrand O, Roche N, Cornet M, Lefebvre A, Peffault de Latour R, et al. Incidence and prognostic value of respiratory events in acute leukemia. Leukemia. 2004;18(4):670–5.

    Article  CAS  PubMed  Google Scholar 

  15. Benoit DD, Vandewoude KH, Decruyenaere JM, Hostle 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(1):104–12.

    Article  PubMed  Google Scholar 

  16. Kroschinsky F, Weise M, Illmer T, Haenel M, Bornhaeuser M, Hoeffken G, et al. Outcome and prognostic features of intensive care unit treatment in patients with hematological malignancies. Intensive Care Med. 2002;28(9):1294–300.

    Article  PubMed  Google Scholar 

  17. Evison J, Rickenbacher P, Ritz R, Gratwohl A, Haberthür C, Elsasser S, et al. Intensive care unit admission in patients with haematological disease: incidence, outcome and prognostic factors. Swiss Med Wkly. 2001;131(47–48):681–6.

    CAS  PubMed  Google Scholar 

  18. Ferrà C, Marcos P, Misis M, Morgades M, Bordejé ML, Oriol A, et al. Outcome and prognostic factors in patients with hematologic malignancies admitted to the intensive care unit: a single center experience. Int J Hematol. 2007;85(3):195–202.

    Article  PubMed  Google Scholar 

  19. Massion PB, Dive AM, Doyen C, Bulpa P, Jamart J, Bosly A, Installé E. Prognosis of hematologic malignancies does not predict intensive care unit mortality. Crit Care Med. 2002;30(10):2260–70.

    Article  PubMed  Google Scholar 

  20. Ñamendys SA, González-Herrera MO, García-Guillén FJ, Texcocano-Becerra J, Herrera-Gomez A. Outcome of critically ill patients with hematological malignancies. Ann Hematol. 2013;92:699–705.

    Article  Google Scholar 

  21. Christakis NA, Lamont EB. Extend and determinants of error in doctors’ prognoses in terminally ill patients: prospective cohort study. BMJ. 2000;320(7233):469–72.

    Google Scholar 

  22. Azoulay E, Schlemmer B. Diagnostic strategy in cancer patients with acute respiratory failure. Intensive Care Med. 2006;32:808–22.

    Article  PubMed  Google Scholar 

  23. Azevedo LC, Caruso P, Silva UVA, Torelly AP, Silva E, Rezende E, et al. Outcomes for patients with cancer admitted to the ICU requiring ventilatory support. Chest. 2014;146(2):257–66.

    Article  PubMed  Google Scholar 

  24. Vallot F, Paesmans M, Berghmans T, Sculier JP. Leucopenia is an independent predictor in cancer patients requiring invasive mechanical ventilation: a prognostic factor analysis in a series of 168 patients. Support Care Cancer. 2003;11:236–41.

    CAS  PubMed  Google Scholar 

  25. Azoulay E, Thiéry G, Chevret S, Moreau D, Darmon M, Bergeron A, et al. The prognosis of acute respiratory failure in critically ill cancer patients. Medicine (Baltimore). 2004;83(6):360–70.

    Article  Google Scholar 

  26. Depuydt PO, Benoit DD, Vandewoudee KH, Decruyenaere JM, Colardyn FA. Outcome in noninvasively and invasively ventilated hematologic patients with acute respiratory failure. Chest. 2004;126:1299–306.

    Article  PubMed  Google Scholar 

  27. Soares M, Salluh JI, Spector N, Rocco JR. Characteristics and outcomes of cancer patients requiring mechanical ventilatory support for >24 hrs. Crit Care Med. 2005;33:520–6.

    Article  PubMed  Google Scholar 

  28. Azoulay E, Mokart D, Rabbat A, Pene F, Kouatchet A, Bruneel F, et al. Diagnostic bronchoscopy in hematology and oncology patients with acute respiratory failure: prospective multicenter data. Crit Care Med. 2008;36:100–7.

    Article  PubMed  Google Scholar 

  29. Lecuyer L, Chevret S, Guidet B, Aegerter P, Martel P, Schelemmer B, Azoulay E. Case volume and mortality in haematological patients with acute respiratory failure. Eur Respir J. 2008;32:748–54.

    Article  CAS  PubMed  Google Scholar 

  30. Kim YJ, Kim MJ, Cho YJ, Park JS, Kim JW, Lee JO, et al. Who should be admitted to the intensive care unit? The outcome of intensive care unit admission in stage IIIB-IV lung cancer patients. Med Oncol. 2014;31:847.

    Article  PubMed  Google Scholar 

  31. Kacmarek RM. Should noninvasive ventilation be used with the do-not-intubate patient? Respir Care. 2009;54(2):223–9.

    PubMed  Google Scholar 

  32. Peters SG, Holets SR, Gay PC. High-flow nasal cannula therapy in do-not-intubate patients with hypoxemic respiratory distress. Respir Care. 2013;58(4):597–600.

    PubMed  Google Scholar 

  33. Fernandez R, Baigorri F, Artigas A. Noninvasive ventilation in patients with “do-not-intubate” orders: medium-term efficacy depends critically on patient selection. Intensive Care Med. 2007;33:350–4.

    Article  PubMed  Google Scholar 

  34. Levy M, Tanios MA, Nelson D, Short K, Senechia A, Vespia J, Hill NS. Outcomes of patients with do-not-intubate orders treated with noninvasive ventilation. Crit Care Med. 2004;32:2002–7.

    Article  PubMed  Google Scholar 

  35. Schettino G, Altobelli N, Kacmarek RM. Noninvasive positive pressure ventilation reverses acute respiratory failure in select “do-not-intubate” patients. Crit Care Med. 2005;33:1976–82.

    Article  PubMed  Google Scholar 

  36. Schortgen F, Follin A, Piccari L, Roche-Campo F, Carteaux G, Taillandier-Heriche E, et al. Results of noninvasive ventilation in very old patients. Ann Intensive Care. 2012;2:5.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Nava S, Grassi M, Fanfulla F, Domenighetti G, Carlucci A, Perren A, et al. Non-invasive ventilation in eldery patients with acute hypercapnic respiratory failure: a randomized controlled trial. Age Ageing. 2011;40:444–50.

    Article  PubMed  Google Scholar 

  38. Cuomo A, Delmastro M, Ceriana P, Nava S, Conti G, Antonelli M, Iacobone E. Noninvasive mechanical ventilation as palliative treatment of acute respiratory failure in patients with end-stage solid cancer. Palliat Med. 2004;18(7):602–10.

    Article  PubMed  Google Scholar 

  39. Adda M, Coquet I, Darmon M, Thierry G, Schlemmer B, Azoulay E. Predictors of noninvasive ventilation failure in patients with hematologic malignancy and acute respiratory failure. Crit Care Med. 2008;36(10):2766–72.

    Article  PubMed  Google Scholar 

  40. Saillard C, Mokart D, Lemaile V, Azoulay E. Mechanical ventilation in cancer patients. Minerva Anestesiol. 2014;80:712–25.

    CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Respiratory Intensive Care Unit, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico

    Thierry Hernández-Gilsoul M.D.

  2. Disaster Medicine Department Chief, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

    Thierry Hernández-Gilsoul M.D.

Authors
  1. Thierry Hernández-Gilsoul M.D.
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Corresponding author

Correspondence to Thierry Hernández-Gilsoul M.D. .

Editor information

Editors and Affiliations

  1. Intensive Care and Non Invasive Ventilatory Unit, Hospital Morales Meseguer, Murcia, Spain

    Antonio M. Esquinas

  2. Division of Anesthesiology and Critical Care, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA

    S. Egbert Pravinkumar

  3. Wayne State University School of Medicine, Detroit, Michigan, USA

    AYMAN O. SOUBANI

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Hernández-Gilsoul, T. (2018). Outcome: Prognosis Determinants. In: Esquinas, A., Pravinkumar, S., SOUBANI, A. (eds) Mechanical Ventilation in Critically Ill Cancer Patients. Springer, Cham. https://doi.org/10.1007/978-3-319-49256-8_30

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  • DOI: https://doi.org/10.1007/978-3-319-49256-8_30

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-49255-1

  • Online ISBN: 978-3-319-49256-8

  • eBook Packages: MedicineMedicine (R0)

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