title: Acute respiratory distress syndrome in patients with hematological malignancies.
abstract: BACKGROUND
  We investigated the clinical course and mortality of acute respiratory distress syndrome (ARDS) in patients with hematological malignancies.
  
  
  METHODS
  Sixty-eight patients with hematological malignancies and ARDS admitted to medical intensive care unit (ICU) of a university hospital were analyzed semi-prospectively in the study.
  
  
  RESULTS
  The most common etiology of ARDS was pneumonia. The ratio of partial pressure of oxygen in arterial blood to fractional concentration of inspired oxygen (PO2/FiO2) was 104 (74-165). Ten patients (15%) received non-invasive mechanical ventilation (NIV), 21 (31%) received invasive mechanical ventilation (MV), and 36 (53%) received both NIV and invasive MV. ICU mortality was 77% in the cohort. None of the variables with relevance to the underlying hematological disease was associated with mortality. The presence of two or more organ failures was the only independent risk factor for mortality (P = 0.045), whereas NIV was associated with low mortality (P = 0.001). The Kaplan-Meier curve of mortality, with respect to the type of MV support, demonstrated that NIV was associated with the lowest mortality (P < 0.001).
  
  
  CONCLUSIONS
  The mortality of ARDS in critically ill patients with hematological malignancies is quite high. The presence of multi-organ failure is independently associated with high mortality whereas the use of NIV is independently associated with low mortality.
authors: Department of Medical Intensive Care Unit, Gazi University School of Medicine, Besevler, Ankara, Turkey. meldaturkoglu@yahoo.com.tr
authors: Melda
authors: M
authors: Türkoğlu
authors: Gökmen Umut
authors: GU
authors: Erdem
authors: Elif
authors: E
authors: Suyanı
authors: Muhammed Erkam
authors: ME
authors: Sancar
authors: Mehmet Muhittin
authors: MM
authors: Yalçın
authors: Gülbin
authors: G
authors: Aygencel
authors: Zeynep
authors: Z
authors: Akı
authors: Gülsan
authors: G
authors: Sucak
mesh_terms: D000328:Adult; D001784:Blood Gas Analysis; D015331:Cohort Studies; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D017052:Hospital Mortality; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D011014:Pneumonia / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D012307:Risk Factors