Citation Information :
Nagarkar S. The role of noninvasive ventilation in cancer patients with acute respiratory failure. Indian J Crit Care Med 2007; 11 (1):25-28.
The poor prognosis of ventilated patients with cancers, especially hematological malignancies, has been a major incentive in the use non-invasive ventilation in such patients. With experience of more than a decade, a few recommendations can be made. While experience in non invasive ventilation is of prime importance, it is the early use especially in conditions requiring supplemental oxygen and a drop in SaO 2 of > 10% that the most benefit is expected. Use of the helmet to provide noninvasive ventilation (NIV) may improve patient compliance. With appropriate use during diagnostic bronchoscopy, NIV may prevent endotracheal intubation. NIV has also been shown to provide relief from dyspnoea to a select group of do-not-intubate patients. While outcome in this group of patients is poor, appropriate use of NIV has been shown to reduce mortality. The coming years and more experience will improve our understanding and refine the use of this modality in this critical condition.
Survival of patients with cancer in a medical critical care unit. Ann Intern Med 1982;142:527-9.
Improved survival in cancer patients requiring mechanical ventilatory support: Impact of non-invasive mechanical ventilatory support. Crit Care Med 2001;29:519-25.
Outcome and early prognostic indicators in patients with a hematological malignancy admitted to the intensive care unit for a life threatening complication. Crit Care Med 2003;31:104-12.
Diagnostic strategy in cancer patients with acute respiratory failure. Intensive Care Med 2006;32:808-22.
Performance of six severity of illness scores in cancer patients requiring admission to the intensive care unit: A prospective observational study. Crit Care 2004;8:R194-203.
Prognostic factors for neutropenic patients in an intensive care unit: Respective roles of underlying malignancies and acute organ failure. Eur J Cancer 1997;33:1031-7.
Predictors of short-term mortality in critically ill patients with solid malignancies. Intensive Care Med 2000 26:1817-23.
Complications of translaryngeal intubation. In: Tobin MJ. Principles and practice of mechanical ventilation. McGraw-Hill: New York, NY; 1994. p. 711-47.
Treatment of acute respiratory failure with non-invasive intermittent positive pressure ventilation in hematological patients. Clin Intensive Care 1994;5:282-8.
Noninvasive ventilation in immunodepressed patients with pulmonary infiltrates. N Engl J Med 2001;344:481-7.
Noninvasive ventilation by helmet or face mask in immunocompromized patients. A case-control study. Chest 2004;126:1508-15.
Noninvasive positive pressure ventilation using a helmet in patient with acute exacerbation of chronic obstructive pulmonary disease: A feasibility study. Anesthesiology 2004;100:16-24.
Predictive factors of intensive care unit admission in patients with haematological malignancies and pneumonia. Intensive Care Med 2004;30:965-71.
Predictors of failure of noninvasive positive pressure ventilation in patients with acute hypoxemic respiratory failure: A multicentre study. Intensive Care Med 2001;27:1718-28.
Non invasive pressure ventilation in severe community acquired pneumonia. Intensive Care Med 2001;27:812-21.
Thiery 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;83:360-70.
Characteristics and outcomes of cancer patients requiring mechanical ventilatory support for> 24 hrs survival. Crit Care Med 2005;33:520-6.
Noninvasive positive pressure ventilation via facemask during bronchoscopy with BAL in high-risk hypoxic patients. Chest 1996;110:724-8.
Continuous positive airway pressure during fibreoptic bronchoscopy in hypoxemic patients: A randomized double-blind study using a new device. Am J Respir Crit Care Med 2000;162:1063-7.
Fiberoptic bronchoscopy during noninvasive positive pressure ventilation delivered by helmet. Intensive Care Med 2003;29:126-9.
Outcomes of patients with do-not-intubate orders treated with non-invasive ventilation. Crit Care Med 2004;32:2002-7.