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Journal of critical care · Apr 2019
ReviewOutcome of invasive mechanical ventilation in cancer patients: Intubate or not to intubate a patient with cancer.
- Armando J Huaringa and Wassem H Francis.
- Loma Linda University School of Medicine, White Memorial Medical Center, Los Angeles, California, Former Faculty, The University of Texas M. D. Anderson Cancer Center, Houston, TX, United States. Electronic address: huaringa@sbcglobal.net.
- J Crit Care. 2019 Apr 1; 50: 87-91.
PurposeThe outcome of cancer patients who undergo mechanical ventilation has been grim. However, it has lately become more promising, creating hesitation when approaching the decision to intubate a cancer patient. Therefore, the main goal was to find some factors that could predict mortality.Material And MethodsStudies were selected on the basis of their information wholeness, the year done, patients' number, participating country, underlying hematological or nonhematological malignancies, ventilation duration, ICU survival, hospital survival, long term survival, disease activity, and other contributing factors.ResultsTwenty-two studies were included which accrued 3115 patients. The average ICU survival was 32.4%, and long-term survival was 10.2%. Over the years, the outcome of cancer patients undergoing mechanical ventilation has improved. The most important predicting factors are: The respiratory failure etiology, the performance status, the disease activity, and the SOFA score.ConclusionsThe aforementioned predicting factors could be used when approaching the decision to intubate. When in doubt, we should give the benefit to the patient, proceed to intubate and reevaluate progress daily and in doing so, we would suggest to use the trends in SOFA score and weaning index to assess success or failure of invasive mechanical ventilation.Copyright © 2018 Elsevier Inc. All rights reserved.
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