Early tracheotomy in neutropenic, mechanically ventilated patients: rationale and results of a pilot study

ISSN:
1433-7339
Keywords:
Tracheotomy ; Endotracheal intubation ; Mechanical ventilation ; Neutropenia ; Cancer
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Despite substantial advances in the management of such patients, the prognosis of ventilated neutropenic patients remains grim. The objective of our study was to evaluate the benefit of tracheotomy in this category of patients, in terms of mortality while they were in the intensive-care unit and nosocomial pneumonias. The charts of 53 consecutive, ventilated, neutropenic patients, or those destined to be imminently neutropenic, admitted to our intensive-care unit during a 4-year period, have been retrospectively reviewed. Tracheotomy was performed at the bedside or in the operating room: 20 patients underwent tracheotomy within 48 h of mechanical ventilation (ET group), while 33 were tracheotomized later or remained intubated (INT group). The two groups were comparable with regard to the underlying disease, respiratory failure, mechanical ventilation patterns and severity scores, but neutropenia was more profound in the ET group. Mortality while in the intensivecare unit was similar (ET:70%; INT:78.8%). However, the survival curves showed a trend towards longer survival in the ET group, even after adjustment for the degree of neutropenia (log-rank test: P=0.07). The incidence of pneumonias was similar in both groups. No major complications of tracheotomy were reported. These findings suggest that a tracheotomy could be proposed for neutropenic patients requiring mechanical ventilation, in order to prologn their survival beyond the end of the neutropenic period. A prospective study is underway to confirm these preliminary results.
Type of Medium:
Electronic Resource
URL:
_version_ 1798296042435772416
autor Blot, F.
Antoun, S.
Leclercq, B.
Nitenberg, G.
Escudier, B.
Gurguet, M.
autorsonst Blot, F.
Antoun, S.
Leclercq, B.
Nitenberg, G.
Escudier, B.
Gurguet, M.
book_url http://dx.doi.org/10.1007/BF00335304
datenlieferant nat_lic_papers
hauptsatz hsatz_simple
identnr NLM206014279
issn 1433-7339
journal_name Supportive care in cancer
materialart 1
notes Abstract Despite substantial advances in the management of such patients, the prognosis of ventilated neutropenic patients remains grim. The objective of our study was to evaluate the benefit of tracheotomy in this category of patients, in terms of mortality while they were in the intensive-care unit and nosocomial pneumonias. The charts of 53 consecutive, ventilated, neutropenic patients, or those destined to be imminently neutropenic, admitted to our intensive-care unit during a 4-year period, have been retrospectively reviewed. Tracheotomy was performed at the bedside or in the operating room: 20 patients underwent tracheotomy within 48 h of mechanical ventilation (ET group), while 33 were tracheotomized later or remained intubated (INT group). The two groups were comparable with regard to the underlying disease, respiratory failure, mechanical ventilation patterns and severity scores, but neutropenia was more profound in the ET group. Mortality while in the intensivecare unit was similar (ET:70%; INT:78.8%). However, the survival curves showed a trend towards longer survival in the ET group, even after adjustment for the degree of neutropenia (log-rank test: P=0.07). The incidence of pneumonias was similar in both groups. No major complications of tracheotomy were reported. These findings suggest that a tracheotomy could be proposed for neutropenic patients requiring mechanical ventilation, in order to prologn their survival beyond the end of the neutropenic period. A prospective study is underway to confirm these preliminary results.
package_name Springer
publikationsjahr_anzeige 1995
publikationsjahr_facette 1995
publikationsjahr_intervall 8004:1995-1999
publikationsjahr_sort 1995
publisher Springer
reference 3 (1995), S. 291-296
schlagwort Tracheotomy
Endotracheal intubation
Mechanical ventilation
Neutropenia
Cancer
search_space articles
shingle_author_1 Blot, F.
Antoun, S.
Leclercq, B.
Nitenberg, G.
Escudier, B.
Gurguet, M.
shingle_author_2 Blot, F.
Antoun, S.
Leclercq, B.
Nitenberg, G.
Escudier, B.
Gurguet, M.
shingle_author_3 Blot, F.
Antoun, S.
Leclercq, B.
Nitenberg, G.
Escudier, B.
Gurguet, M.
shingle_author_4 Blot, F.
Antoun, S.
Leclercq, B.
Nitenberg, G.
Escudier, B.
Gurguet, M.
shingle_catch_all_1 Blot, F.
Antoun, S.
Leclercq, B.
Nitenberg, G.
Escudier, B.
Gurguet, M.
Early tracheotomy in neutropenic, mechanically ventilated patients: rationale and results of a pilot study
Tracheotomy
Endotracheal intubation
Mechanical ventilation
Neutropenia
Cancer
Tracheotomy
Endotracheal intubation
Mechanical ventilation
Neutropenia
Cancer
Abstract Despite substantial advances in the management of such patients, the prognosis of ventilated neutropenic patients remains grim. The objective of our study was to evaluate the benefit of tracheotomy in this category of patients, in terms of mortality while they were in the intensive-care unit and nosocomial pneumonias. The charts of 53 consecutive, ventilated, neutropenic patients, or those destined to be imminently neutropenic, admitted to our intensive-care unit during a 4-year period, have been retrospectively reviewed. Tracheotomy was performed at the bedside or in the operating room: 20 patients underwent tracheotomy within 48 h of mechanical ventilation (ET group), while 33 were tracheotomized later or remained intubated (INT group). The two groups were comparable with regard to the underlying disease, respiratory failure, mechanical ventilation patterns and severity scores, but neutropenia was more profound in the ET group. Mortality while in the intensivecare unit was similar (ET:70%; INT:78.8%). However, the survival curves showed a trend towards longer survival in the ET group, even after adjustment for the degree of neutropenia (log-rank test: P=0.07). The incidence of pneumonias was similar in both groups. No major complications of tracheotomy were reported. These findings suggest that a tracheotomy could be proposed for neutropenic patients requiring mechanical ventilation, in order to prologn their survival beyond the end of the neutropenic period. A prospective study is underway to confirm these preliminary results.
1433-7339
14337339
Springer
shingle_catch_all_2 Blot, F.
Antoun, S.
Leclercq, B.
Nitenberg, G.
Escudier, B.
Gurguet, M.
Early tracheotomy in neutropenic, mechanically ventilated patients: rationale and results of a pilot study
Tracheotomy
Endotracheal intubation
Mechanical ventilation
Neutropenia
Cancer
Tracheotomy
Endotracheal intubation
Mechanical ventilation
Neutropenia
Cancer
Abstract Despite substantial advances in the management of such patients, the prognosis of ventilated neutropenic patients remains grim. The objective of our study was to evaluate the benefit of tracheotomy in this category of patients, in terms of mortality while they were in the intensive-care unit and nosocomial pneumonias. The charts of 53 consecutive, ventilated, neutropenic patients, or those destined to be imminently neutropenic, admitted to our intensive-care unit during a 4-year period, have been retrospectively reviewed. Tracheotomy was performed at the bedside or in the operating room: 20 patients underwent tracheotomy within 48 h of mechanical ventilation (ET group), while 33 were tracheotomized later or remained intubated (INT group). The two groups were comparable with regard to the underlying disease, respiratory failure, mechanical ventilation patterns and severity scores, but neutropenia was more profound in the ET group. Mortality while in the intensivecare unit was similar (ET:70%; INT:78.8%). However, the survival curves showed a trend towards longer survival in the ET group, even after adjustment for the degree of neutropenia (log-rank test: P=0.07). The incidence of pneumonias was similar in both groups. No major complications of tracheotomy were reported. These findings suggest that a tracheotomy could be proposed for neutropenic patients requiring mechanical ventilation, in order to prologn their survival beyond the end of the neutropenic period. A prospective study is underway to confirm these preliminary results.
1433-7339
14337339
Springer
shingle_catch_all_3 Blot, F.
Antoun, S.
Leclercq, B.
Nitenberg, G.
Escudier, B.
Gurguet, M.
Early tracheotomy in neutropenic, mechanically ventilated patients: rationale and results of a pilot study
Tracheotomy
Endotracheal intubation
Mechanical ventilation
Neutropenia
Cancer
Tracheotomy
Endotracheal intubation
Mechanical ventilation
Neutropenia
Cancer
Abstract Despite substantial advances in the management of such patients, the prognosis of ventilated neutropenic patients remains grim. The objective of our study was to evaluate the benefit of tracheotomy in this category of patients, in terms of mortality while they were in the intensive-care unit and nosocomial pneumonias. The charts of 53 consecutive, ventilated, neutropenic patients, or those destined to be imminently neutropenic, admitted to our intensive-care unit during a 4-year period, have been retrospectively reviewed. Tracheotomy was performed at the bedside or in the operating room: 20 patients underwent tracheotomy within 48 h of mechanical ventilation (ET group), while 33 were tracheotomized later or remained intubated (INT group). The two groups were comparable with regard to the underlying disease, respiratory failure, mechanical ventilation patterns and severity scores, but neutropenia was more profound in the ET group. Mortality while in the intensivecare unit was similar (ET:70%; INT:78.8%). However, the survival curves showed a trend towards longer survival in the ET group, even after adjustment for the degree of neutropenia (log-rank test: P=0.07). The incidence of pneumonias was similar in both groups. No major complications of tracheotomy were reported. These findings suggest that a tracheotomy could be proposed for neutropenic patients requiring mechanical ventilation, in order to prologn their survival beyond the end of the neutropenic period. A prospective study is underway to confirm these preliminary results.
1433-7339
14337339
Springer
shingle_catch_all_4 Blot, F.
Antoun, S.
Leclercq, B.
Nitenberg, G.
Escudier, B.
Gurguet, M.
Early tracheotomy in neutropenic, mechanically ventilated patients: rationale and results of a pilot study
Tracheotomy
Endotracheal intubation
Mechanical ventilation
Neutropenia
Cancer
Tracheotomy
Endotracheal intubation
Mechanical ventilation
Neutropenia
Cancer
Abstract Despite substantial advances in the management of such patients, the prognosis of ventilated neutropenic patients remains grim. The objective of our study was to evaluate the benefit of tracheotomy in this category of patients, in terms of mortality while they were in the intensive-care unit and nosocomial pneumonias. The charts of 53 consecutive, ventilated, neutropenic patients, or those destined to be imminently neutropenic, admitted to our intensive-care unit during a 4-year period, have been retrospectively reviewed. Tracheotomy was performed at the bedside or in the operating room: 20 patients underwent tracheotomy within 48 h of mechanical ventilation (ET group), while 33 were tracheotomized later or remained intubated (INT group). The two groups were comparable with regard to the underlying disease, respiratory failure, mechanical ventilation patterns and severity scores, but neutropenia was more profound in the ET group. Mortality while in the intensivecare unit was similar (ET:70%; INT:78.8%). However, the survival curves showed a trend towards longer survival in the ET group, even after adjustment for the degree of neutropenia (log-rank test: P=0.07). The incidence of pneumonias was similar in both groups. No major complications of tracheotomy were reported. These findings suggest that a tracheotomy could be proposed for neutropenic patients requiring mechanical ventilation, in order to prologn their survival beyond the end of the neutropenic period. A prospective study is underway to confirm these preliminary results.
1433-7339
14337339
Springer
shingle_title_1 Early tracheotomy in neutropenic, mechanically ventilated patients: rationale and results of a pilot study
shingle_title_2 Early tracheotomy in neutropenic, mechanically ventilated patients: rationale and results of a pilot study
shingle_title_3 Early tracheotomy in neutropenic, mechanically ventilated patients: rationale and results of a pilot study
shingle_title_4 Early tracheotomy in neutropenic, mechanically ventilated patients: rationale and results of a pilot study
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source_archive Springer Online Journal Archives 1860-2000
timestamp 2024-05-06T09:45:48.044Z
titel Early tracheotomy in neutropenic, mechanically ventilated patients: rationale and results of a pilot study
titel_suche Early tracheotomy in neutropenic, mechanically ventilated patients: rationale and results of a pilot study
topic WW-YZ
uid nat_lic_papers_NLM206014279