Acute and chronic respiratory failure in cancer patients

Steven P. Sears, Gordon Carr, Christian Bime

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

In 2016, there was an estimated 1.8 million new cases of cancer diagnosed in the United States. Remarkable advances have been made in cancer therapy and the 5-year survival has increased for most patients affected by malignancy. There are growing numbers of patients admitted to intensive care units (ICU) and up to 20% of all patients admitted to an ICU carry a diagnosis of malignancy. Respiratory failure remains the most common reason for ICU admission and remains the leading causes of death in oncology patients. There are many causes of respiratory failure in this population. Pneumonia is the most common cause of respiratory failure, yet there are many causes of respiratory insufficiency unique to the cancer patient. These causes are often a result of immunosuppression, chemotherapy, radiation treatment, or hematopoietic stem cell transplant (HCT). Treatment is focused on supportive care and specific therapy for the underlying cause of respiratory failure. Noninvasive modalities of respiratory support are available; however, careful patient selection is paramount as indiscriminate use of noninvasive positive pressure ventilation is associated with a higher mortality if mechanical ventilation is later required. Historically, respiratory failure in the cancer patient had a grim prognosis. Outcomes have improved over the past 20 years. Survivors are often left with significant disability.

Original languageEnglish (US)
Title of host publicationOncologic Critical Care
PublisherSpringer International Publishing
Pages445-475
Number of pages31
ISBN (Electronic)9783319745886
ISBN (Print)9783319745879
DOIs
StatePublished - Oct 12 2019

Keywords

  • Bronchoscopy
  • Diffuse alveolar hemorrhage
  • High resolution computed tomography
  • Intensive care unit
  • Mechanical ventilation
  • Noninvasive ventilation
  • Organizing pneumonia
  • Pulmonary embolism
  • Respiratory failure

ASJC Scopus subject areas

  • Medicine(all)

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