Rubenfeld and Crawford evaluated bone marrow transplant patients who required mechanical ventilation in the intensive care unit (ICU). They identified factors associated with a poor prognosis in these patients. The authors are from the University of Washington and the Fred Hutchinson Cancer Research Center.


Patient selection: bone marrow transplant recipient admitted to the ICU and requiring mechanical ventilation


Patient exclusion: previous bone marrow transplant; required mechanical ventilation for less than 24 hours


Period of evaluation: first 4 days of mechanical ventilation


Risk factors:

(1) presence of lung injury (FIO2 > 0.6 or PEEP > 5 cm H2O after the first 24 hours of mechanical ventilation)

(2) hepatic and renal failure during the first 3 days of mechanical ventilation (total serum bilirubin > 4 mg/dL and serum creatinine > 2 mg/dL)

(3) required vasopressor therapy for > 4 hours in any 24 hour period (dopamine > 5 µg/kg/min or norepinephrine or epinephrine or phenylephrine)

Risk Factors

Survival in 1992



lung injury only


hepatic and renal failure only


vasopressors only


vasopressors AND hepatic/renal failure


any other combination



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