Prognosis of Hematological Cancer Patient Underwent Mechanical Ventillation

Study Overview
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Brief Summary
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This observational cohort aimed to re-evaluate the outcome of hematologic cancer patients admitted to the intensive care unit of Mansoura oncology center through a cohort study as regards their need for mechanical ventilation during two years.

Detailed Description
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It has been believed for many years that the scene of cancer patients requiring mechanical ventilation is frustrating. The needed life support measures drain much of health resources and add a significant burden on the patient's family. Many factors have been responsible for the high mortality rates among hematologic cancer patients admitted to intensive care unit. Among of these factors, the invasive treatments that are frequently employed in today's intensive care unit. These procedures give chance for development of severe infection and multiple organ failure which are common events in immune-compromised patients (e.g. neutropenia) and in those exposed to chemotherapy. The most common form of organ failure in those patients is acute respiratory failure which is a major predictor of mortality in that population. The prognosis of such failure may vary depending on its causes and severity, co morbidity, associated acute organ failure and characters of the underlying malignancy. After the recent advances in the field of intensive care and shedding light on the benefits of the noninvasive ventilation in immune-compromised patients, the overall survival rate of cancer patients admitted to intensive care unit are improving.

Official Title
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In a Developing Country; What is the Fate of Hematologic Cancer Patients Requiring Mechanical Ventilation for More Than One Day? A Prospective Cohort Study

Conditions
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Hematological Malignancy, Acute Respiratory Failure, Mechanical Ventilation

Intervention / Treatment
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* Procedure: Mechanical ventilation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Critical ill hematological cancer patient Requiring mechanical ventilation Exclusion Criteria: Patients with acute coronary syndrome. Patients with cancer remission more than 5 years.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Mechanical ventilation<br>requiring mechanical ventilation at admission to ICU for one day or more during the study period | Procedure: Mechanical ventilation<br>* requiring mechanical ventilation at admission to ICU for one day or more during the study period<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Survival | Continuing to live | through study completion, an average of 30 days after admission to intensive care unit | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sequential Organ Failure Assessment score | Sequential Organ Failure Assessment (SOFA) Score | up to 24 hours after admission to the intensive care unit | 
| Simplified Acute Physiology Score II | Simplified Acute Physiology Score (SAPS II) | up to 24 hours after admission to the intensive care unit | 
| Mode of mechanical ventilation | synchronised intermittent, pressure-controlled, volume-controlled, pressure support, continuous positive airway pressure, volume guarantee, adjusted pressure release ventilation, or adaptive proportional assist ventilation | up to 24 hours after admission to the intensive care unit | 
| lowest Pa02/FiO2 | PaO2 arterial oxygen tension/FiO2 inspired fraction of oxygen ratio | up to 24 hours after admission to the intensive care unit | 
| Reason for need of ventilatory support | Advanced malignancy, respiratory muscle weakness, respiratory failure, lung metastasis, coma, sepsis, multi-organs failure | up to 24 hours after admission to the intensive care unit | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Intensive care unit, Hematological malignancy, Acute respiratory failure, Prognosis, Mechanical ventilation