Researchers, led by Katharine McLaughlin, examined the relationship between changes in vital signs and admission to an intensive care unit (ICU) in patients with acute myeloid or lymphoblastic leukemia following induction chemotherapy. They reported that respiratory rate (RR) and fraction of expired oxygen (FiO2) requirement changes predicted disease deterioration that led to ICU admission, which was consistent with the most common reason for ICU admission in the cohort, respiratory failure.
The retrospective analysis, published in Hematology included seven ICU patients and 30 controls. Changes in heart rate, mean arterial pressure, temperature, RR, and FiO2 needed to maintain stable oxygen saturation were compared to baseline levels over the 24 hours prior to ICU admission, or the five days following chemotherapy initiation.
RR and FiO2 vital signs in the ICU patients demonstrated significant change over baseline prior to ICU admission. However, temperature, heart rate, and mean arterial pressure did not demonstrate significant changes over time in either group. RR, FiO2, and heart rate were significantly higher in the ICU group at the start of data collection compared with the control group.
The authors suggested that their findings provide support for using more in-depth monitoring of RR and FiO2 vitals in acute leukemia patients as a predictor of disease deterioration—and administering early interventions if RR and FiO2 vitals change.