Non-invasive Ventilation in Cancer Patients: a historically matched controlled study

Abstract

Prognosis of cancer patients requiring Invasive Mechanical Ventilation (IMV) is poor. Various studies conducted mainly in patients with haematological malignancies have shown that Non-Invasive Ventilation (NIV) is associated with improved results OBJECTIVE: To compare NIV with IMV in patients with various malignancies. An assessment was also made of the possible bias in our results due to recent improvements in IMV. MATERIAL AND METHODS: A historically matched controlled study of NIV versus IMV. Forty seven patients treated by NIV were matched with 47 historical controls treated by IMV. Matching was performed according to 5 variables: type of cancer, leucopenia, allogeneic bone marrow transplantation, SAPS II score and reason for ventilation. RESULTS: Duration of ventilation and of hospitalisation were significantly (p=0.001) shorter in the NIV group; 48% of patients treated with NIV were discharged from the hospital versus 23% of those treated by IMV (p=0.08). NIV was statistically more effective than IMV in solid tumours, non transplanted and non leucopenic patients. Contrary to the period before 1996, when the analysis was restricted to the IMV matched cases, in the period since 1996, no difference in terms of mortality between IMV and NIV was found. CONCLUSIONS: In comparison with IMV, NIV in cancer patients: is associated with two significant advantages: reduction in ventilation duration and reduction in hospitalisation stay.