title: Deterioration of previous acute lung injury during neutropenia recovery.
abstract: METHODS
  Although neutropenia recovery is associated with a high risk of deterioration of respiratory condition, no studies designed to identify risk factors for acute respiratory distress syndrome (ARDS) in this situation have been published.
  
  
  METHODS
  Medical ICU in a French teaching hospital.
  
  
  METHODS
  We conducted a study to describe critically ill cancer patients with ARDS during neutropenia recovery (defined as the 7-day period centered on the day the neutrophil count rose above 1000/mm3 [day 0]) and to compare them with critically ill cancer patients without ARDS during neutropenia recovery.
  
  
  METHODS
  None.
  
  
  RESULTS
  During a 10-yr period, 62 critically ill cancer patients recovered from neutropenia, of whom 21 experienced ARDS during neutropenia recovery, with a median time of -1 days (-2.5-1) between day 0 and ARDS. In-ICU mortality in these 21 patients was 61.9%. As compared with non-ARDS patients, ARDS patients were less likely to have myeloma and more likely to have leukemia/lymphoma treated with adriamycin, a history of pneumonia before neutropenia, and a neutropenia duration >10 days; they had a shorter time since malignancy diagnosis and a longer time from chemotherapy to neutropenia. Neither the leukocyte counts on day 0 nor those during the 6-day neutropenia recovery period were predictive of ARDS.
  
  
  CONCLUSIONS
  Patients with acute respiratory failure after prolonged neutropenia complicated by pneumonia are at increased risk for ARDS.
authors.affiliation: Medical Intensive Care Unit, Saint Louis University Hospital, USA.
authors.forename: Elie
authors.initials: E
authors.lastname: Azoulay
authors.forename: Michael
authors.initials: M
authors.lastname: Darmon
authors.forename: Christophe
authors.initials: C
authors.lastname: Delclaux
authors.forename: Fabienne
authors.initials: F
authors.lastname: Fieux
authors.forename: Caroline
authors.initials: C
authors.lastname: Bornstain
authors.forename: Delphine
authors.initials: D
authors.lastname: Moreau
authors.forename: Habiba
authors.initials: H
authors.lastname: Attalah
authors.forename: Jean-Roger
authors.initials: JR
authors.lastname: Le Gall
authors.forename: Benoît
authors.initials: B
authors.lastname: Schlemmer
mesh_terms: D000328:Adult; D000368:Aged; D016638:Critical Illness; D006801:Humans; D007362:Intensive Care Units; D007958:Leukocyte Count; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D009503:Neutropenia / Q000150:complications*; D011014:Pneumonia / Q000150:complications; D012128:Respiratory Distress Syndrome / Q000503:physiopathology*; D012131:Respiratory Insufficiency / Q000209:etiology; D012307:Risk Factors