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Prone Ventilatory Therapy in Critically Ill Cancer Patients

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Oncologic Critical Care

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Abstract

Mortality in critically ill cancer patients requiring mechanical ventilation approaches 60%. When mechanical ventilation is required for severe hypoxemia and acute respiratory distress syndrome, mortality ranges from 70% to 100%, with worse outcomes in patients with hematologic malignancy and stem cell transplant. While overall mortality has improved with the use of lung protective strategies like low tidal volume ventilation and conservative fluid management, prone positioning has been shown to improve gas exchange and decrease ventilator-associated lung injury. By recruiting collapsed lung units and redistributing transpulmonary pressures, prone positioning is associated with improved hemodynamics, decreased organ dysfunction, and improved mortality. Observational studies and retrospective case series suggest that prone positioning may improve mortality in patients with cancer and ARDS but in practice may be underutilized.

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Authors and Affiliations

  1. Department of Internal Medicine, University of California San Diego, La Jolla, San Diego, CA, USA

    Alex Pearce & Rebecca E. Sell

  2. Division of Pulmonary & Critical Care, University of California San Diego, San Diego, CA, USA

    Rebecca E. Sell

Authors
  1. Alex Pearce
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  2. Rebecca E. Sell
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Correspondence to Alex Pearce .

Editor information

Editors and Affiliations

  1. Department of Critical Care, University of Texas MD Anderson Cancer C Department of Critical Care, Houston, TX, USA

    Joseph L. Nates

  2. Department of Critical Care, University of Texas MD Anderson Cancer C Department of Critical Care, Houston, TX, USA

    Kristen J. Price

Section Editor information

  1. Critical Care Department, Universidad del Rosario Hospital Universitario Fundacion Santa Fe de, Bogota, Colombia, Colombia

    Yenny Cardenas

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Pearce, A., Sell, R.E. (2019). Prone Ventilatory Therapy in Critically Ill Cancer Patients. In: Nates, J., Price, K. (eds) Oncologic Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-74698-2_57-1

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  • DOI: https://doi.org/10.1007/978-3-319-74698-2_57-1

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  • Print ISBN: 978-3-319-74698-2

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