Acute Respiratory Distress Syndrome (ARDS) in Neutropenic Patients

Abstract

Lung involvement is common in febrile neutropenic patients. Early radiologic lung infiltrates occur in two-thirds of severely neutropenic patients developing a fever and are associated with high mortality rates. The most frequent etiology of pulmonary infiltrates in neutropenic patients is bacterial pneumonia, followed by filamentous fungi. Interestingly, although the role for neutrophils has been extensively studied in non-neutropenic patients with acute lung injury and ARDS, the pathophysiology of ARDS in patients with neutrophil depletion remains unclear. Numerous studies have documented the occurrence of authentic ARDS in patients with severe neutropenia. This chapter reviews the most likely pathophysiological mechanisms involved in ARDS in neutropenic patients and highlights the points of ARDS management that are specific of neutropenic patients.