title: Noninvasive ventilation during acute respiratory distress syndrome in patients with cancer: Trends in use and outcome.
abstract: The objectives of our study were to describe the outcome of patients with malignancies treated for acute respiratory distress syndrome (ARDS) with noninvasive ventilation (NIV) and to evaluate factors associated with NIV failure.
  
  
  
  Post hoc analysis of a multicenter database within 20 years was performed. All patients with malignancies and Berlin ARDS definition were included. Noninvasive ventilation use was defined as NIV lasting more than 1 hour, whereas failure was defined as a subsequent requirement of invasive ventilation. Conditional backward logistic regression analyses were conducted.
  
  
  
  A total of 1004 met the Berlin definition of ARDS. Noninvasive ventilation was used in 387 patients (38.6%) and NIV failure occurred in 71%, with an in-hospital mortality of 62.7%. Severity of ARDS defined by the partial pressure arterial oxygen and fraction of inspired oxygen ratio (odds ratio [OR], 2.20; 95% confidence interval [CI], 1.15-4.19), pulmonary infection (OR, 1.81; 95% CI, 1.08-3.03), and modified Sequential Organ Failure Assessment (SOFA) score (OR, 1.13; 95% CI, 1.06-1.21) were associated with NIV failure. Factors associated with hospital mortality were NIV failure (OR, 2.52; 95% CI, 1.56-4.07), severe ARDS as compared with mild ARDS (OR, 1.89; 95% CI, 1.05-1.19), and modified SOFA score (OR, 1.12; 95% CI, 1.05-1.19).
  
  
  
  Noninvasive ventilation failure in ARDS patients with malignancies is frequent and related to ARDS severity, SOFA score, and pulmonary infection-related ARDS. Noninvasive ventilation failure is associated with in-hospital mortality.
authors.affiliation: ICU, Saint Louis Teaching Hospital, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Neuschwander
authors.affiliation: ICU, Saint Louis Teaching Hospital, Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Lemiale
authors.affiliation: ICU, Saint Etienne, Teaching Hospital, France.
authors.forename: M
authors.initials: M
authors.lastname: Darmon
authors.affiliation: ICU, Cochin Teaching Hospital, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Pène
authors.affiliation: ICU, Angers Teaching Hospital, Angers, France.
authors.forename: A
authors.initials: A
authors.lastname: Kouatchet
authors.affiliation: ICU, Brabois Teatching Hospital, Nancy, France.
authors.forename: P
authors.initials: P
authors.lastname: Perez
authors.affiliation: ICU, Monfermeil Hospital, Montfermeil, France.
authors.forename: F
authors.initials: F
authors.lastname: Vincent
authors.affiliation: ICU Pitié Salpétrière Teaching Hospital, Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Mayaux
authors.affiliation: ICU, Ghent Teaching Hospital, Ghent, Belgium.
authors.forename: D
authors.initials: D
authors.lastname: Benoit
authors.affiliation: ICU, Mignot Hospital, Versailles, France.
authors.forename: F
authors.initials: F
authors.lastname: Bruneel
authors.affiliation: ICU, Bordet Institut, Bruxelles, Belgium.
authors.forename: A P
authors.initials: AP
authors.lastname: Meert
authors.affiliation: ICU, Roubaix Hospital, Roubaix, France.
authors.forename: M
authors.initials: M
authors.lastname: Nyunga
authors.affiliation: ICU, Cochin Teaching Hospital, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Rabbat
authors.affiliation: ICU, Paoli Calmettes Institut Marseilles, Marseilles, France.
authors.forename: D
authors.initials: D
authors.lastname: Mokart
authors.affiliation: ICU, Saint Louis Teaching Hospital, Paris, France. Electronic address: elie.azoulay@aphp.fr.
authors.forename: E
authors.initials: E
authors.lastname: Azoulay
mesh_terms: D000368:Aged; D001604:Berlin; D001784:Blood Gas Analysis; D016208:Databases, Factual; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007938:Leukemia / Q000150:complications; D008172:Lung Diseases, Fungal / Q000150:complications*; D008228:Lymphoma, Non-Hodgkin / Q000150:complications; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications; D009369:Neoplasms / Q000150:complications*; D063087:Noninvasive Ventilation / Q000639:trends*; D063305:Organ Dysfunction Scores; D011014:Pneumonia / Q000150:complications; D018410:Pneumonia, Bacterial / Q000150:complications*; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000628:therapy*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017211:Treatment Failure; D016896:Treatment Outcome
keywords: Mechanical ventilation; Noninvasive ventilation; Outcome