Prognostic Impact of Neutropenia Recovery and G-CSF Use in Onco-Hematological Neutropenic Patients Admitted to Intensive Care Unit for Acute Respiratory Failure: A Retrospective, Real World Analysis.

Autor: Secreto C; Division of Hematology, Department of Oncology, A.O.U. Città Della Salute e della Scienza di Torino, Turin, Italy. carolina.secreto@gmail.com., Morel B; Department of Anesthesiology and Intensive Care Unit, Institut Paoli-Calmettes, Marseille, France., Bisbal M; Department of Anesthesiology and Intensive Care Unit, Institut Paoli-Calmettes, Marseille, France., Pennors W; Department of Anesthesiology and Intensive Care Unit, Institut Paoli-Calmettes, Marseille, France., Pouliquen C; Department of Anesthesiology and Intensive Care Unit, Institut Paoli-Calmettes, Marseille, France., Albanese J; Department of Anesthesiology and Intensive Care Unit, Institut Paoli-Calmettes, Marseille, France., Leone M; Department of Anesthesiology and Intensive Care Medicine, Nord Hospital, Assistance Publique Hôpitaux Universitaires de Marseille, Aix Marseille University, Marseille, France., Cerrano M; Division of Hematology, Department of Oncology, A.O.U. Città Della Salute e della Scienza di Torino, Turin, Italy., Servan L; Department of Anesthesiology and Intensive Care Unit, Institut Paoli-Calmettes, Marseille, France., Gonzalez F; Department of Anesthesiology and Intensive Care Unit, Institut Paoli-Calmettes, Marseille, France., Faucher M; Department of Anesthesiology and Intensive Care Unit, Institut Paoli-Calmettes, Marseille, France., Chow-Chine L; Department of Anesthesiology and Intensive Care Unit, Institut Paoli-Calmettes, Marseille, France., Sannini A; Department of Anesthesiology and Intensive Care Unit, Institut Paoli-Calmettes, Marseille, France., Mokart D; Department of Anesthesiology and Intensive Care Unit, Institut Paoli-Calmettes, Marseille, France.
Jazyk: angličtina
Zdroj: Advances in therapy [Adv Ther] 2024 Nov 09. Date of Electronic Publication: 2024 Nov 09.
DOI: 10.1007/s12325-024-03029-y
Abstrakt: Introduction: The effect of neutropenia and the use of granulocyte colony-stimulating factor (G-CSF) in critically ill patients with cancer are controversial, notably in those with lung injury. Neutropenia recovery can be associated with an acute respiratory failure (ARF) requiring intensive care unit (ICU) admission, especially when G-CSF is administered.
Methods: In a single-center retrospective study, we evaluated (1) the effect of neutropenia recovery on the 90-day mortality and (2) the impact of G-CSF use on the outcome of patients with cancer and neutropenia with ARF admitted to the ICU.
Results: Among 1098 screened patients, 152 were neutropenic at ICU admission. The 90-day mortality was 44.7%. Factors independently associated with the 90-day mortality were invasive mechanical ventilation, ground-glass opacities and nodules on computed tomography scans, a disease in progression and the Simplified Acute Physiology Score (SAPS II) at ICU admission. The lack of neutropenia recovery during the ICU stay was associated with the 90-day mortality. Using G-CSF had no effect on the 90-day mortality or the neutropenia duration, but the PaO 2 :FiO 2 ratio was significantly lower after neutropenia recovery in patients who received G-CSF. Thus, respiratory deterioration can occur in the neutropenia recovery period, potentially exacerbated by G-CSF.
Conclusion: Our study suggests that neutropenia recovery was associated with survival in critically ill patients with cancer and neutropenia with ARF admitted to ICU, and the G-CSF could worsen the respiratory parameters.
(© 2024. The Author(s), under exclusive licence to Springer Healthcare Ltd., part of Springer Nature.)
Databáze: MEDLINE
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