Outcome from mechanical ventilation after autologous peripheral blood stem cell transplantation.
OBJECTIVE
To report the outcome of patients with autologous peripheral blood stem cell transplantation (PBSCT) receiving mechanical ventilation.


METHODS
Retrospective observational study.


METHODS
Active hematopoietic stem cell transplantation center and a university hospital medical ICU.


METHODS
Patients with autologous PBSCT receiving mechanical ventilation.


METHODS
A review of the medical records of patients with autologous PBSCT receiving mechanical ventilation. Data collection was restricted to the first episode of mechanical ventilation.


RESULTS
A total of 78 autologous PBSCT patients received mechanical ventilation for > 24 h. Twenty patients (26%) were extubated and discharged alive from the hospital. Thirteen hospital survivors (60%) were alive at 6 months. Lung injury (LI), vasopressor use, and hepatic and renal failure (HRF) were used to predict survival after mechanical ventilation. Sixty patients (76%) had no organ failure, or had isolated LI or only required treatment with vasopressors. Their hospital survival and 6-month survival were 32% and 20%, respectively. Hospital and 6-month survival for the patients with HRF or LI and vasopressor use was 6% and 0%, respectively.


CONCLUSIONS
Prolonged mechanical ventilation and aggressive ICU support is justified for autologous PBSCT patients receiving mechanical ventilation with no organ failure, or who have only isolated LI, or who only require treatment with vasopressors.
Khassawneh
Basheer Y
BY
Division of Pulmonary and Critical Care Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
White
Peter
P
Anaissie
Elias J
EJ
Barlogie
Barthel
B
Hiller
F Charles
FC
D000328:Adult; D000368:Aged; D002423:Cause of Death; D003422:Critical Care; D019091:Critical Pathways; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D017052:Hospital Mortality; D006801:Humans; D008223:Lymphoma / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality / Q000628:therapy; D009102:Multiple Organ Failure / Q000401:mortality*; D009369:Neoplasms / Q000401:mortality / Q000628:therapy; D011175:Positive-Pressure Respiration; D012131:Respiratory Insufficiency / Q000401:mortality*; D012307:Risk Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome