Acute Lung Injury After Allogeneic Transplantation - Diagnosis and Early Treatment

A Randomized Clinical Trial on the Use of Early Intermittent Non-Invasive Ventilation in Patients Suffering From Acute Lung Injury After Allogeneic Transplantation

Acute lung injury (ALI) is an early complication after allogeneic transplantation causing significant mortality and morbidity. Little is known on early markers and treatment of this complication. Recent data (Hilbert et al.) suggested a beneficial effect of Non-Invasive-Ventilation in ALI-patients immunosuppressed because a many different reasons including stem-cell transplantation.

The investigators study is designed to evaluate early markers of ALI after allogeneic transplantation. In case ALI is documented patients are randomized to either conventional therapy (oxygen-support) or conventional therapy plus intermittent Non-Invasive Ventilation. The hypothesis is that Non-Invasive Ventilation improves outcome of ALI after allogeneic transplantation.

Inclusion Criteria:

patients undergoing allogeneic transplantation presenting with at least two of the following criteria

• Respiratory rate >25 / min
• Oxygenation Index <300
• Continuous oxygen-saturation <92% whilst breathing room air

Exclusion Criteria:

• Indication for Emergency intubation
• Hemodynamic instability
• Left ventricular failure
• GCS <8
• No consent