血液恶性肿瘤（HM）患者发生的急性呼吸窘迫综合征（ARDS）是一种具有特定特征的危及生命的疾病。死亡率仍然很高，但过去几年有所改善。我们的目的是描述一年期间入住法国 ICU（重症监护病房）的 HM 患者的 ARDS 特征和结果。这项全国性队列研究的数据收集自法国国家医院数据库（信息系统医疗计划（PMSI））。 2017 年入住法国 ICU 且诊断为 ARDS 的所有患者（18 岁或以上）均纳入其中。根据 HM、实体癌或无癌症的存在情况对三组进行比较。主要终点是 90 天死亡率。次要终点是 ICU 管理情况、ARDS 病因和死亡危险因素的描述。共纳入 12 846 例 ARDS 患者。其中，990 人患有 HM，2744 人患有实体癌。主要恶性肿瘤为非霍奇金淋巴瘤（NHL）（28.5%）、急性髓系白血病（AML）（20.4%）和多发性骨髓瘤（19.7%）。 HM 患者的第 90 天死亡率高于无癌症患者（64.4% vs. 46.6%，p = 0.01），但与实体癌患者没有差异（64.4% vs. 61.4%，p = 0.09） 。与两组相比，HM 患者的插管率较低（实体癌患者为 87.7% vs. 90.4%，p = 0.02；无癌症患者为 87.7% vs. 91.3%；p< 0.01）。 HM 患者死亡率的独立预测因素是淋巴瘤或急性白血病的诊断、年龄、修改后的 SAPS II 评分高、肾脏替代治疗、侵袭性真菌感染和感染性休克。细菌性肺炎、肺外感染和无创通气具有保护作用。与非癌症患者相比，因 ARDS 入住 ICU 的 HM 患者死亡率仍然很高。该人群的死亡率预测因素包括淋巴瘤或急性白血病的诊断、年龄、修改后的 SAPS II 高评分、肾脏替代疗法、侵袭性真菌感染和败血性休克。© 2024。作者。

Acute respiratory distress syndrome (ARDS) occurring in patients with hematological malignancies (HM) is a life-threatening condition with specific features. Mortality rate remains high but improvement has been described over the past several years. We aimed to describe characteristics and outcomes of ARDS in HM patients admitted in French ICUs (Intensive Care Units) during a one year-period. Data for this nationwide cohort study were collected from the French national hospital database (Programme de Médicalisation des Systèmes d'Information (PMSI)). All patients (18 years or older) admitted to French ICUs in 2017 and with a diagnosis of ARDS were included. Three groups were compared according to the presence of an HM, a solid cancer or no cancer. The primary endpoint was 90-day mortality. Secondary endpoints were the description of ICU management, etiologies of ARDS and mortality risk factors.A total of 12 846 patients with ARDS were included. Among them, 990 had HM and 2744 had a solid cancer. The main malignancies were non-Hodgkin lymphoma (NHL) (28.5%), acute myeloid leukemia (AML) (20.4%) and multiple myeloma (19.7%). Day-90 mortality in patients with HM was higher than in patients with no cancer (64.4% vs. 46.6% p = 0.01) but was not different from that of patients with solid cancer (64.4% vs. 61.4%,p = 0.09). Intubation rate was lower in patients with HM in comparison with both groups (87.7% vs. 90.4% p = 0.02 for patients with solid cancer and 87.7% vs. 91.3%; p < 0.01 with no cancer). Independent predictors of mortality for patients with HM were a diagnosis of lymphoma or acute leukemia, age, a high modified SAPS II score, a renal replacement therapy, invasive fungal infection, and a septic shock. Bacterial pneumonia, extrapulmonary infections and non-invasive ventilation were protective.Mortality remains high in patients with HM admitted in ICU with ARDS in comparison with patients without cancer. Mortality predictors for this population were a diagnosis of lymphoma or acute leukemia, age, a high modified SAPS II score, a renal replacement therapy, invasive fungal infection and a septic shock.© 2024. The Author(s).