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Noninvasive Positive-Pressure Ventilation in Patients With Malignancy

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, paul.marik{at}jefferson.edu

Noninvasive positive-pressure ventilation (NIPPV) is now accepted as the treatment of choice for subgroups of patients with acute respiratory failure. Noninvasive positive-pressure ventilation has traditionally not been considered in the management strategy of patients with malignancy; however, this mode of ventilatory support may be appropriate in some specific situations. Noninvasive positive-pressure ventilation is the preferred initial mode of ventilatory support in patients with hematologic malignancies or after bone marrow transplantation who develop acute respiratory failure. In these patients, NIPPV should be initiated early; severe respiratory distress and altered mental status require conventional mechanical ventilation. Noninvasive positive-pressure ventilation should be considered in select patients with cancer who develop respiratory failure and have a do-not-intubate code status. In rare instances, NIPPV may have a role in treating patients with advanced cancer who have intractable dyspnea; however, NIPPV should not be used for the sole purpose of prolonging life in patients with terminal respiratory failure.

Key Words: palliation • noninvasive ventilation • NIPPV • cancer • bone marrow transplant • hematologic malignancy • respiratory failure

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American Journal of Hospice and Palliative Medicine®, Vol. 24, No. 5, 417-421 (2007)
DOI: 10.1177/1049909107307370


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This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Marik, P. E. Search for Related Content PubMed PubMed Citation Articles by Marik, P. E. Pubmed/NCBI databases Medline Plus Health Information Breathing Problems Cancer Social Bookmarking                         What's this?