Chest
Clinical Investigations in Critical CareOutcome From Mechanical Ventilation After Autologous Peripheral Blood Stem Cell Transplantation
Section snippets
Materials and Methods
This was an observational study. All patients who received autologous PBSCT at UAMS between March 1, 1991, and April 30, 1999, were eligible for the study. The UAMS Human Research Advisory Committee approved the study.
Autologous PBSCT patients with acute respiratory failure requiring mechanical ventilation were transferred to the university hospital medical ICU, a closed ICU where patients are cared for by the pulmonary and critical care staff and fellows, and the internal medicine house staff.
Study Population
From March 1991 to April 1999, 1,301 patients received autologous PBSCT at UAMS. Seventy-eight patients (6%) received mechanical ventilation for ≥ 24 h. The mean age was 55.4 ± 12 years. Sixty-two percent were male patients. The indications for transplantation were multiple myeloma (n = 68; 87%), solid tumors (n = 7; 9%), and lymphoma (n = 3; 4%). The median duration of mechanical ventilation was 7 days (range, 1 to 63 days).
Hospital Survival and Mechanical Ventilation
Hospital survival for the autologous PBSCT patients was 20 of 78
Discussion
This study describes the survival for a large group of autologous PBSCT patients receiving mechanical ventilation. The principle finding of this study was that autologous PBSCT patients receiving mechanical ventilation without organ failure or with isolated LI or isolated vasopressor use represented 77% of all BSCT patients receiving mechanical ventilation, and those patients had better hospital survival (32%) than autologous PBSCT patients receiving mechanical ventilation with LI and
Conclusion
Hospital survival for autologous PBSCT patients receiving mechanical ventilation who did not have two-organ failure was 32%, and prolonged mechanical ventilation is justified.
ACKNOWLEDGMENT
The authors thank Mr. Clyde Bailey from the Myeloma and Transplantation Research Center, Miss Angela Johnson from Medical Records, and Mr. Trey Spencer from the Department of Biostatistics.
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