Table 2 Studies that do not support NIV in HM patients for ARF
From: Management strategy for hematological malignancy patients with acute respiratory failure
Study | Design | Patients | Setting | Inclusion criteria | comparison | Rate of NIV failure | HRs of NIV failure | Mortality | Comments |
|---|---|---|---|---|---|---|---|---|---|
Depuydt, 2004 | Retrospective | 166 | ICU | HM patients who needed ventilation support | NIV/IMV | 69% | N/A | NIV:65.4%, NIV failure:91.7% IMV: 65.4% | IMV should considered for HM with ARF, especially when ICU admission was driven by bacteremia |
Adda, 2008 | Retrospective | 99 | ICU | PO2/FiO2 < 300 | N/A | 54% | high RR under NIV, longer delay between admission and NIV, need for vasopressors or RRT, and ARDS | NIV success: 41%; NIV failure: 79% | NIV failure was associated with increased mortality and complications. Predictors of NIV failure can be used to guide intubation |
Depuydt, 2010 | Retrospective | 137 | ICU | PO2/FiO2 < 200 | Oxygen/NIV/IMV | 75% | N/A | ICU mortality: NIV:71%, IMV:63%, Oxygen:32% | Mortality was determined by severity of illness rather than initial ventilation support |
Wermke, 2012 | RCT | 86(allo-HSCT) | wards | PO2/FiO2 < 300, SO2 < 92%, RR > 25 | Oxygen/NIV | 76% | N/A | 100-day mortality: NIV: 39%; Oxygen: 32% | NIV did not reduce need of intubation and mortality, but study design limited the efficacy |
Lemial, 2015 | RCT | 374(283 HM) | ICU | Immunocompromised patients with ARF | Oxygen/NIV | 38.20% | N/A | 28-day mortality: NIV: 24.1%; Oxygen:27.3% | Early NIV couldn't reduce 28-day mortality compared to oxygen alone |
Lemial, 2015 | Prospective | 380 | ICU | SO2 < 90%, or RR > 30 | Oxygen/NIV | 29% | N/A | NIV: 27%; Oxygen: 25% | NIV did not show benefit for HM with ARF, IMV should not be delayed |
Liu, 2017 | Retrospective | 79 | ICU | HM patients who received NIV ventilation | N/A | 65% | high FiO2, high PCO2, vasopressor use | NIV success:21%; NIV failure: 74% | NIV failure was associated with high mortality |