Medicina intensiva · 2023
Factors associated with short- and long-term outcomes in lung cancer patients requiring unplanned invasive mechanical ventilation.
Наблюдательное исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Chatelain Emeric, Simon Marie, Hernu Romain, Argaud Laurent, Cour Martin
Аннотация
OBJECTIVE: Unplanned invasive mechanical ventilation (IMV) is associated with high mortality in lung cancer patients. We aimed to identify factors associated with weaning from IMV, intensive care unit (ICU) survival and 1-year survival in lung cancer patients requiring unplanned IMV.
DESIGN: Retrospective observational study (2007-2017).
SETTING: University-affiliated ICU.
PATIENTS: Lung cancer patients requiring unplanned IMV.
INTERVENTION: None.
MAIN VARIABLES OF INTEREST: Weaning from IMV, ICU and 1-year survival.
RESULTS: Of the 136 patients included in the analysis (age 64 (9) years, male 110 (81%), metastatic disease 97 (62%)), 52 (38%) were weaned from IMV, 51 (38%) were discharged from ICU and 22 (16%) were alive at 1year. The main indication for intubation was acute respiratory failure. In multivariate analysis, PaO2/FiO2 >175mmHg at ICU admission and intubation before ICU admission were associated with successful weaning from IMV while intubation for cardiac arrest was associated with weaning failure. Same factors were associated with ICU survival. Absence of metastasis at ICU admission and lung resection surgery were independently associated with 1-year survival.
CONCLUSIONS: A significant proportion of patients with lung cancer treated with unplanned IMV could be weaned from IMV and survived to ICU discharge, especially in the absence of severe hypoxemia at ICU admission. The low one-year survival was mostly driven by metastatic status.
DESIGN: Retrospective observational study (2007-2017).
SETTING: University-affiliated ICU.
PATIENTS: Lung cancer patients requiring unplanned IMV.
INTERVENTION: None.
MAIN VARIABLES OF INTEREST: Weaning from IMV, ICU and 1-year survival.
RESULTS: Of the 136 patients included in the analysis (age 64 (9) years, male 110 (81%), metastatic disease 97 (62%)), 52 (38%) were weaned from IMV, 51 (38%) were discharged from ICU and 22 (16%) were alive at 1year. The main indication for intubation was acute respiratory failure. In multivariate analysis, PaO2/FiO2 >175mmHg at ICU admission and intubation before ICU admission were associated with successful weaning from IMV while intubation for cardiac arrest was associated with weaning failure. Same factors were associated with ICU survival. Absence of metastasis at ICU admission and lung resection surgery were independently associated with 1-year survival.
CONCLUSIONS: A significant proportion of patients with lung cancer treated with unplanned IMV could be weaned from IMV and survived to ICU discharge, especially in the absence of severe hypoxemia at ICU admission. The low one-year survival was mostly driven by metastatic status.