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Factors affecting survival in children requiring intensive care after hematopoietic stem cell transplantation. A retrospective single-center study.
Szmit, Zofia; Kosmider-Zurawska, Magdalena; Król, Anna; Lobos, Monika; Miskiewicz-Bujna, Justyna; Zielinska, Marzena; Kalwak, Krzysztof; Mielcarek-Siedziuk, Monika; Salamonowicz-Bodzioch, Malgorzata; Fraczkiewicz, Jowita; Ussowicz, Marek; Owoc-Lempach, Joanna; Gorczynska, Ewa.
Afiliação
  • Szmit Z; Department of Pediatric Hematology/Oncology and BMT, Supraregional Center of Pediatric Oncology "Cape of Hope", Wroclaw Medical University, Wroclaw, Poland.
  • Kosmider-Zurawska M; Department of Anesthesiology and Intensive Care, Wroclaw Medical University, Wroclaw, Poland.
  • Król A; Department of Anesthesiology and Intensive Care, Wroclaw Medical University, Wroclaw, Poland.
  • Lobos M; Department of Pediatric Hematology/Oncology and BMT, Supraregional Center of Pediatric Oncology "Cape of Hope", Wroclaw Medical University, Wroclaw, Poland.
  • Miskiewicz-Bujna J; Department of Pediatric Hematology/Oncology and BMT, Supraregional Center of Pediatric Oncology "Cape of Hope", Wroclaw Medical University, Wroclaw, Poland.
  • Zielinska M; Department of Pediatric Hematology/Oncology and BMT, Supraregional Center of Pediatric Oncology "Cape of Hope", Wroclaw Medical University, Wroclaw, Poland.
  • Kalwak K; Department of Anesthesiology and Intensive Care, Wroclaw Medical University, Wroclaw, Poland.
  • Mielcarek-Siedziuk M; Department of Pediatric Hematology/Oncology and BMT, Supraregional Center of Pediatric Oncology "Cape of Hope", Wroclaw Medical University, Wroclaw, Poland.
  • Salamonowicz-Bodzioch M; Department of Pediatric Hematology/Oncology and BMT, Supraregional Center of Pediatric Oncology "Cape of Hope", Wroclaw Medical University, Wroclaw, Poland.
  • Fraczkiewicz J; Department of Pediatric Hematology/Oncology and BMT, Supraregional Center of Pediatric Oncology "Cape of Hope", Wroclaw Medical University, Wroclaw, Poland.
  • Ussowicz M; Department of Pediatric Hematology/Oncology and BMT, Supraregional Center of Pediatric Oncology "Cape of Hope", Wroclaw Medical University, Wroclaw, Poland.
  • Owoc-Lempach J; Department of Pediatric Hematology/Oncology and BMT, Supraregional Center of Pediatric Oncology "Cape of Hope", Wroclaw Medical University, Wroclaw, Poland.
  • Gorczynska E; Department of Pediatric Hematology/Oncology and BMT, Supraregional Center of Pediatric Oncology "Cape of Hope", Wroclaw Medical University, Wroclaw, Poland.
Pediatr Transplant ; 24(5): e13765, 2020 08.
Article em En | MEDLINE | ID: mdl-32558076
Allo-HSCT is associated with life-threatening complications. Therefore, a considerable number of patients require admission to a PICU. We evaluated the incidence and outcome of PICU admissions after allo-HSCT in children, along with the potential factors influencing PICU survival. A retrospective chart review of 668 children who underwent first allo-HSCT in the Department of Pediatric Hematology/Oncology and BMT in Wroclaw during years 2005-2017, particularly focusing on patients admitted to the PICU within 1-year post-HSCT. Fifty-eight (8.7%) patients required 64 admissions to the PICU. Twenty-four (41.5%) were discharged, and 34 (58.6%) patients died. Among the discharged patients, 6-month survival was 66.7%. Compared with survivors, death cases were more likely to have required MV (31/34; 91.2% vs. 16/24; 66.7% P = .049), received more aggressive cardiac support (17/34; 50% vs. 2/24; 8.3% P = .002), and had a lower ANC on the last day of their PICU stay (P = .004). Five patients were successfully treated with NIV and survived longer than 6 months post-discharge. The intensity of cardiac support and ANC on the last day of PICU treatment was independent factors influencing PICU survival. Children admitted to the PICU after allo-HSCT have a high mortality rate. Mainly those who needed a more aggressive approach and had a lower ANC on the last day of treatment had a greater risk of death. While requiring MV is associated with decreased PICU survival, early implementation of NIV might be considered.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Transplante de Células-Tronco Hematopoéticas / Cuidados Críticos Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Transplante de Células-Tronco Hematopoéticas / Cuidados Críticos Idioma: En Ano de publicação: 2020 Tipo de documento: Article