Cancer patients with ARDS: survival gains and unanswered questions

Excerpt

Acute respiratory distress syndrome (ARDS) is a devastating diffuse pulmonary inflammation, triggered by a wide array of direct and indirect pulmonary insults, but frequently leading down the common path of acute respiratory failure (ARF) requiring mechanical ventilation (MV), multiorgan dysfunction, and death despite advanced organ support. While no single therapy with curative potential for ARDS has been identified yet, a multimodality approach, including restrictive ventilator settings to limit additional iatrogenic lung injury, careful patient positioning, and judicious use of muscle relaxants, has however led to gradual but marked improvements in survival over the last two decades [1]. Nevertheless, when short-term death is averted, ARDS very often leaves the patient in a debilitated state from which functional recovery is protracted and often incomplete and long-term post-hospital mortality is disproportionally high [2‐4]. Of note, severe comorbidities are prevalent in ARDS patients and further contribute to worsen long-term morbidity and mortality in these patients [4]. …