Virginia Tech Carilion School of Medicine, Section of Pulmonary, Critical Care, Environmental, and Sleep Medicine, Carilion Clinic, 1906 Belleview Avenue, Roanoke, VA 24014, USA.
Lung. 2012 Oct;190(5):471-6. doi: 10.1007/s00408-012-9394-8. Epub 2012 May 30.
Utilization of intensive care services by patients with malignancy has risen during the past several decades. Newer cancer therapies have improved overall survival and outcomes. Patients with respiratory failure from central airway obstruction related to tumor growth were previously viewed as inappropriate candidates for ventilator support. However, an increasing number of reports suggest that interventional pulmonary (IP) procedures may benefit such patients.
We reviewed the literature for case reports or case series from the past 20 years regarding the use of IP procedures for the treatment of respiratory failure from malignancy-associated central airway obstruction.
As a whole, IP procedures were greater than 60 % successful in liberating patients from mechanical ventilation. Moreover, IP procedures served to palliate respiratory symptoms, prolong overall survival, allow for additional cancer treatments, and reduce hospitalization costs. Nevertheless, it remains unclear who may benefit the most from these procedures.
Although data are limited, IP procedures are generally safe and should be considered for appropriate patients with respiratory failure from malignancy-associated central airway obstruction as a potential means of liberation from mechanical ventilation.
在过去几十年中，患有恶性肿瘤的患者对重症监护服务的利用率有所上升。新型癌症疗法改善了整体生存率和预后。由于肿瘤生长导致中央气道阻塞而导致呼吸衰竭的患者以前被视为呼吸机支持的不合适人选。但是，越来越多的报告表明，介入性肺病（IP）程序可能对这些患者有益。
我们回顾了过去 20 年中有关使用 IP 程序治疗与恶性肿瘤相关的中央气道阻塞引起的呼吸衰竭的病例报告或病例系列的文献。
总体而言，IP 程序使超过 60％的患者成功摆脱机械通气。此外，IP 程序可缓解呼吸症状，延长总生存期，允许进行更多的癌症治疗并降低住院费用。尽管如此，仍不清楚谁最能从这些程序中受益。
尽管数据有限，但 IP 程序通常是安全的，对于因恶性肿瘤相关中央气道阻塞而导致呼吸衰竭的合适患者，应考虑将其作为从机械通气中解脱的潜在手段。
