Jan 16, 2003

Prognosis of child recipients of hematopoietic stem cell transplantation requiring intensive care

Intensive Care Medicine
Adelaida LamasIsabel Martos

Abstract

To determine prognostic factors in child recipients of hematopoietic stem cell transplantation from blood or bone marrow (BMT) requiring critical care. Retrospective study of a cohort of patients. Pediatric Intensive Care Unit (PICU) in a university tertiary care center. Child recipients of BMT requiring PICU admission. Of the 151 children receiving transplants in our institution, 44 (29.1%) had 49 admissions to the PICU. Mechanical ventilation (MV) was required in 34 patients (69.4% of all admissions). Overall mortality was 31/44 (70.4%). Mortality in patients requiring MV and not requiring MV was 26/34 (76.5%) and 5/10 (50%), respectively. The following variables were significantly associated with mortality in the univariate analysis: male gender (P=0.02), older age (P=0.03), acute graft versus host disease (aGVHD) grades III or IV (P=0.01), severe hemorrhagic cystitis (P=0.01), the diagnosis of lung injury (P=0.04), the need for MV (P=0.03) or for renal replacement therapy (P=0.02), the presence of respiratory (P=0.003), cardiovascular (P=0.009) or gastrointestinal (P=0.01) failures, and the failure of > or =3 organs (P=0.01). In the multivariate analysis, the presence of aGVHD grades III or IV, male gender, severe hemorrhag...Continue Reading

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Mentioned in this Paper

Pediatric Intensive Care Unit
Lung
Acute GVH Disease
Graft-vs-Host Disease
Bone Marrow
Logistic Regression
Kidney
Organ
Hemorrhagic Cystitis
Lung Diseases

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