Etiology and prognosis of acute respiratory failure in patients with primary malignant brain tumors admitted to the intensive care unit View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2018-12-07

AUTHORS

Maxens Decavèle, Isabelle Rivals, Clémence Marois, Marie Cantier, Nicolas Weiss, Léa Lemasle, Hélène Prodanovic, Khe Hoang-Xuan, Ahmed Idbaih, Thomas Similowski, Alexandre Demoule

ABSTRACT

PurposeAcute respiratory failure (ARF) is common and potentially fatal in patients with primary malignant brain tumors (PMBT). However, few data are available regarding its precipitating factors and prognosis. We sought to: (1) compare the causes of ARF and the outcome between patients with PMBT and patients with other peripheral solid tumors (PST), (2) identify the factors influencing ICU survival in PMBT patients.MethodsTwo-center retrospective case-control study from March 1996 to May 2014. Primary central nervous system lymphomas were also included.ResultsEighty-four patients with PMBT and 133 patients with PST were included. Acute infectious pneumonia was more frequent in PMBT than PST patients (77 vs. 36%, p < 0.001). Pulmonary embolism was also more frequent in PMBT patients (13% vs. 5%, p = 0.042), while cardiogenic pulmonary edema and acute-on-chronic respiratory failure were more frequent in PST patients (37 vs. 10%, p < 0.001). Among acute infectious pneumonia, Pneumocystis pneumonia and aspiration pneumonia were more frequent in PMBT patients (19 vs. 2%, p < 0.001 and 19 vs. 8%, p < 0.001, respectively). ICU mortality was similar between PMBT and PST patients (24% vs. 24%, p = 0.966). In multivariate analysis, cancer progression (OR 7.25 95% CI 1.13–46.45, p = 0.034), need for intubation (OR 7.01 95% CI 1.29–38.54, p = 0.022), were independently associated with ICU mortality in PMBT patients.ConclusionsThe cause of ARF in patients with PMBT differs significantly than those with PST and up to 50% may have been prevented. Mortality did not differ between the two groups. These results suggest that PMBT alone is not a relevant criterion for ICU recusal. More... »

PAGES

139-148

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  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s11060-018-03074-y

    DOI

    http://dx.doi.org/10.1007/s11060-018-03074-y

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1110448822

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30536197


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