PMV in Children with Hemato-Oncologic Disease

Pediatric hematology-oncology patients frequently develop critical illness, resulting in higher mortality than other pediatric patients. Respiratory failure is the leading cause of admission to the pediatric intensive care unit in these patients and commonly results in prolonged need for mechanical ventilation. Critically ill children with cancer with respiratory failure requiring mechanical ventilation have a particularly high mortality, especially post-hematopoietic cell transplantation. Accordingly, recent international consensus identified understanding the appropriate timing and use of invasive and noninvasive mechanical ventilation a priority to improve outcomes for these patients. Understanding the potential causes of and treatments for respiratory failure unique to children with cancer and other blood disorders is integral to improving management and survival. This chapter summarizes what is known regarding risk factors, etiology, management considerations, complications, and research priorities in pediatric hematology-oncology patients requiring prolonged mechanical ventilation (PMV).