Risk factors for acute respiratory distress syndrome during neutropenia recovery in patients with hematologic malignancies
IntroductionNeutropenia 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.
Author: Chin Kook RheeJi Young KangYong Hyun KimJin Woo KimHyung Kyu YoonSeok Chan KimSoon Suk KwonYoung Kyoon KimKwan Hyung KimHwa Sik MoonSung Hak ParkHee Je KimSeok LeeJeong Sup Song
Credits/Source: Critical Care 2009, 13:R173
Published on: 2009-11-03
Copyright by the authors listed above - made available via BioMedCentral (Open Access). Please
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