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

被引：39

作者：

Rhee, Chin Kook ^{[1
]}

Kang, Ji Young ^{[1
]}

Kim, Yong Hyun ^{[1
]}

Kim, Jin Woo ^{[1
]}

Yoon, Hyung Kyu ^{[1
]}

Kim, Seok Chan ^{[1
]}

Kwon, Soon Suk ^{[1
]}

Kim, Young Kyoon ^{[1
]}

Kim, Kwan Hyung ^{[1
]}

Moon, Hwa Sik ^{[1
]}

Park, Sung Hak ^{[1
]}

Kim, Hee Je ^{[2
]}

Lee, Seok ^{[2
]}

Song, Jeong Sup ^{[1
]}

机构：

[1] Catholic Univ Korea, Coll Med, Dept Internal Med, Div Pulm & Crit Care Med, Seoul 137701, South Korea

[2] Catholic Univ Korea, Coll Med, Dept Internal Med, Catholic Hematopoiet Stem Cell Transplantat Ctr, Seoul 137701, South Korea

来源：

CRITICAL CARE | 2009年 / 13卷 / 06期

关键词：

COLONY-STIMULATING FACTOR; ACUTE LUNG INJURY; 3-WEEKLY CHOP CHEMOTHERAPY; INTENSIVE-CARE-UNIT; CANCER-PATIENTS; BONE-MARROW; G-CSF; AGGRESSIVE LYMPHOMAS; PULMONARY TOXICITY; DETERIORATION;

D O I：

10.1186/cc8149

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

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.

引用

页数：8

共 39 条

[1] G-CSF and IL-8 but not GM-CSF correlate with severity of pulmonary neutrophilia in acute respiratory distress syndrome [J].