title: [Ten-year evolution of mechanical ventilation in acute respiratory failure in the hematogical patient admitted to the intensive care unit].
abstract: OBJECTIVE
  A comparison was made between invasive mechanical ventilation (IMV) and noninvasive positive pressure ventilation (NPPV) in haematological patients with acute respiratory failure.
  
  
  METHODS
  A retrospective observational study was made from 2001 to December 2011.
  
  
  METHODS
  A clinical-surgical intensive care unit (ICU) in a tertiary hospital.
  
  
  METHODS
  Patients with hematological malignancies suffering acute respiratory failure (ARF) and requiring mechanical ventilation in the form of either IMV or NPPV.
  
  
  METHODS
  Analysis of infection and organ failure rates, duration of mechanical ventilation and ICU and hospital stays, as well as ICU, hospital and mortality after 90 days. The same variables were analyzed in the comparison between NPPV success and failure.
  
  
  RESULTS
  Forty-one patients were included, of which 35 required IMV and 6 NPPV. ICU mortality was higher in the IMV group (100% vs 37% in NPPV, P=.006). The intubation rate in NPPV was 40%. Compared with successful NPPV, failure in the NPPV group involved more complications, a longer duration of mechanical ventilation and ICU stay, and greater ICU and hospital mortality. Multivariate analysis of mortality in the NPPV group identified NPPV failure (OR 13 [95%CI 1.33-77.96], P=.008) and progression to acute respiratory distress syndrome (OR 10 [95%CI 1.95-89.22], P=.03) as prognostic factors.
  
  
  CONCLUSIONS
  The use of NPPV reduced mortality compared with IMV. NPPV failure was associated with more complications.
authors.affiliation: Servicio de Medicina Intensiva, Hospital General de Castellón, Castellón de la Plana, España. Electronic address: belenguer_alb@gva.es.
authors.forename: A
authors.initials: A
authors.lastname: Belenguer-Muncharaz
authors.forename: L
authors.initials: L
authors.lastname: Albert-Rodrigo
authors.forename: A
authors.initials: A
authors.lastname: Ferrandiz-Sellés
authors.forename: G
authors.initials: G
authors.lastname: Cebrián-Graullera
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000453:epidemiology; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications* / Q000628:therapy; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data / Q000639:trends; D053208:Kaplan-Meier Estimate; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009102:Multiple Organ Failure / Q000453:epidemiology; D063087:Noninvasive Ventilation / Q000706:statistics & numerical data / Q000639:trends; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology; D011175:Positive-Pressure Respiration / Q000706:statistics & numerical data / Q000639:trends; D012121:Respiration, Artificial / Q000706:statistics & numerical data / Q000639:trends*; D012128:Respiratory Distress Syndrome / Q000401:mortality / Q000517:prevention & control / Q000628:therapy; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D013030:Spain; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D017211:Treatment Failure
keywords: Acute respiratory failure; Enfermedad hematológica; Hematological malignancy; Insuficiencia respiratoria aguda; Invasive mechanical ventilation; Neumonía; Noninvasive positive pressure ventilation; Pneumonia; Ventilación mecánica invasiva; Ventilación mecánica no invasiva