The outcome of children requiring admission to an intensive care unit following bone marrow transplantation
We report the results of a retrospective study of the role of intensive care unit (ICU) admission in the management of 367 children who underwent bone marrow transplantation (BMT) at a tertiary referral institution. 39 patients (11%) required 44 ICU admissions for a median of 6 d. 70% received marro...
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| Veröffentlicht in: | British journal of haematology 1998-08, Vol.102 (3), p.666-670 |
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| container_title | British journal of haematology |
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| creator | Hayes, Corinne Lush, Richard J. Cornish, Jacqueline M. Foot, Annabel M. Henderson, John Jenkins, Ian Murphy, Peter Oakhill, Anthony Pamphilon, Derwood H. Steward, Colin G. Weir, Patricia Wolf, Andrew Marks, David I. |
| description | We report the results of a retrospective study of the role of intensive care unit (ICU) admission in the management of 367 children who underwent bone marrow transplantation (BMT) at a tertiary referral institution. 39 patients (11%) required 44 ICU admissions for a median of 6 d. 70% received marrow from unrelated donors, half of which were mismatched; 80% had leukaemia and two‐thirds were considered high‐risk transplants. Respiratory failure was the major reason for admission to ICU. 75% of admissions required mechanical ventilation (for a median of 5 d) and 20 patients had lung injury as defined by the criteria of the Seattle group. None of 11 patients with proven viral pneumonitis survived (P = 0.06) and only one of 20 patients with lung injury survived (P |
| doi_str_mv | 10.1046/j.1365-2141.1998.00817.x |
| format | Article |
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Respiratory failure was the major reason for admission to ICU. 75% of admissions required mechanical ventilation (for a median of 5 d) and 20 patients had lung injury as defined by the criteria of the Seattle group. None of 11 patients with proven viral pneumonitis survived (P = 0.06) and only one of 20 patients with lung injury survived (P < 0.01). Six of seven patients with a primary neurological problem survived (P < 0.001); these appear to represent a good outcome group. Age, the presence of graft‐versus‐host disease, the use of inotropes, isolated renal or hepatic impairment, and paediatric risk of mortality (PRISM) score were not predictive of outcome. In total, 12 patients (27% of admissions) survived and were discharged from hospital 30 d or more after admission and eight (18%) survived >6 months. ICU admission can be beneficial to selected children post‐BMT but it may be less useful in proven viral pneumonitis. Where mechanical ventilation is required, the duration of this support should be limited unless there is rapid improvement.</description><identifier>ISSN: 0007-1048</identifier><identifier>EISSN: 1365-2141</identifier><identifier>DOI: 10.1046/j.1365-2141.1998.00817.x</identifier><identifier>PMID: 9722291</identifier><identifier>CODEN: BJHEAL</identifier><language>eng</language><publisher>Oxford, U.K. and Cambridge, USA: Blackwell Publishers</publisher><subject>Acute Disease ; Adolescent ; Anemia, Aplastic - therapy ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; bone marrow transplantation ; Bone Marrow Transplantation - mortality ; Child ; Child, Preschool ; children ; Critical Care ; Emergency and intensive respiratory care ; Female ; Hematology ; Humans ; Infant ; Intensive care medicine ; intensive care unit ; Leukemia, Myeloid - therapy ; Lung Diseases - etiology ; Lung Diseases - therapy ; lung injury ; Male ; mechanical ventilation ; Medical sciences ; Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy ; Prognosis ; Referral and Consultation ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Survivors</subject><ispartof>British journal of haematology, 1998-08, Vol.102 (3), p.666-670</ispartof><rights>1998 INIST-CNRS</rights><rights>Copyright Blackwell Scientific Publications Ltd. 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Respiratory failure was the major reason for admission to ICU. 75% of admissions required mechanical ventilation (for a median of 5 d) and 20 patients had lung injury as defined by the criteria of the Seattle group. None of 11 patients with proven viral pneumonitis survived (P = 0.06) and only one of 20 patients with lung injury survived (P < 0.01). Six of seven patients with a primary neurological problem survived (P < 0.001); these appear to represent a good outcome group. Age, the presence of graft‐versus‐host disease, the use of inotropes, isolated renal or hepatic impairment, and paediatric risk of mortality (PRISM) score were not predictive of outcome. In total, 12 patients (27% of admissions) survived and were discharged from hospital 30 d or more after admission and eight (18%) survived >6 months. ICU admission can be beneficial to selected children post‐BMT but it may be less useful in proven viral pneumonitis. Where mechanical ventilation is required, the duration of this support should be limited unless there is rapid improvement.</description><subject>Acute Disease</subject><subject>Adolescent</subject><subject>Anemia, Aplastic - therapy</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>bone marrow transplantation</subject><subject>Bone Marrow Transplantation - mortality</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>children</subject><subject>Critical Care</subject><subject>Emergency and intensive respiratory care</subject><subject>Female</subject><subject>Hematology</subject><subject>Humans</subject><subject>Infant</subject><subject>Intensive care medicine</subject><subject>intensive care unit</subject><subject>Leukemia, Myeloid - therapy</subject><subject>Lung Diseases - etiology</subject><subject>Lung Diseases - therapy</subject><subject>lung injury</subject><subject>Male</subject><subject>mechanical ventilation</subject><subject>Medical sciences</subject><subject>Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy</subject><subject>Prognosis</subject><subject>Referral and Consultation</subject><subject>Respiration, Artificial</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Survivors</subject><issn>0007-1048</issn><issn>1365-2141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkUFv1DAQhS0EKkvhJyBZCCEuWcZ2HDsSl1IBBVXiUs6W40yol6y9tRO2_fc47GoPHBCnsfS-N56ZRwhlsGZQN-82ayYaWXFWszVrW70G0Eyt7x-R1Ul4TFYAoKpi0E_Js5w3AEyAZGfkrFWc85atyM-bW6RxnlzcljpQd-vHPmGgCe9mn3z4QW2_9Tn7GOgUqQ3UhwlD9r-QOpuQzsFPdIjjGPcL3cWAdGtTins6JRvybrRhslPxPydPBjtmfHGs5-T7p483l1fV9bfPXy4vrisngauq1azpJOMtgBO8UQ1K0Te1YqhsrYVVAOgaWUvLe90x2fcdcAf1gEz0IFGckzeHvrsU72bMkykLOBzLIBjnbJTQuhGKF_DtP0GmpJCgVN0U9NVf6CbOKZQ1DGu1VFIyVSB9gFyKOScczC75cosHw8AsuZmNWeIxSzxmyc38yc3cF-vLY_-522J_Mh6DKvrro26zs-NQLut8PmFcSF3zumDvD9jej_jw39-bD1-vykP8Blqpsqs</recordid><startdate>199808</startdate><enddate>199808</enddate><creator>Hayes, Corinne</creator><creator>Lush, Richard J.</creator><creator>Cornish, Jacqueline M.</creator><creator>Foot, Annabel M.</creator><creator>Henderson, John</creator><creator>Jenkins, Ian</creator><creator>Murphy, Peter</creator><creator>Oakhill, Anthony</creator><creator>Pamphilon, Derwood H.</creator><creator>Steward, Colin G.</creator><creator>Weir, Patricia</creator><creator>Wolf, Andrew</creator><creator>Marks, David I.</creator><general>Blackwell Publishers</general><general>Blackwell</general><general>Blackwell Publishing Ltd</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>199808</creationdate><title>The outcome of children requiring admission to an intensive care unit following bone marrow transplantation</title><author>Hayes, Corinne ; Lush, Richard J. ; Cornish, Jacqueline M. ; Foot, Annabel M. ; Henderson, John ; Jenkins, Ian ; Murphy, Peter ; Oakhill, Anthony ; Pamphilon, Derwood H. ; Steward, Colin G. ; Weir, Patricia ; Wolf, Andrew ; Marks, David I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5027-9816b512900c32676e53d6471e7a483a700ec6545a2d8b15ddb02c04fe13d05e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Acute Disease</topic><topic>Adolescent</topic><topic>Anemia, Aplastic - therapy</topic><topic>Anesthesia. 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Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>bone marrow transplantation</topic><topic>Bone Marrow Transplantation - mortality</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>children</topic><topic>Critical Care</topic><topic>Emergency and intensive respiratory care</topic><topic>Female</topic><topic>Hematology</topic><topic>Humans</topic><topic>Infant</topic><topic>Intensive care medicine</topic><topic>intensive care unit</topic><topic>Leukemia, Myeloid - therapy</topic><topic>Lung Diseases - etiology</topic><topic>Lung Diseases - therapy</topic><topic>lung injury</topic><topic>Male</topic><topic>mechanical ventilation</topic><topic>Medical sciences</topic><topic>Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy</topic><topic>Prognosis</topic><topic>Referral and Consultation</topic><topic>Respiration, Artificial</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Survivors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hayes, Corinne</creatorcontrib><creatorcontrib>Lush, Richard J.</creatorcontrib><creatorcontrib>Cornish, Jacqueline M.</creatorcontrib><creatorcontrib>Foot, Annabel M.</creatorcontrib><creatorcontrib>Henderson, John</creatorcontrib><creatorcontrib>Jenkins, Ian</creatorcontrib><creatorcontrib>Murphy, Peter</creatorcontrib><creatorcontrib>Oakhill, Anthony</creatorcontrib><creatorcontrib>Pamphilon, Derwood H.</creatorcontrib><creatorcontrib>Steward, Colin G.</creatorcontrib><creatorcontrib>Weir, Patricia</creatorcontrib><creatorcontrib>Wolf, Andrew</creatorcontrib><creatorcontrib>Marks, David I.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of haematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hayes, Corinne</au><au>Lush, Richard J.</au><au>Cornish, Jacqueline M.</au><au>Foot, Annabel M.</au><au>Henderson, John</au><au>Jenkins, Ian</au><au>Murphy, Peter</au><au>Oakhill, Anthony</au><au>Pamphilon, Derwood H.</au><au>Steward, Colin G.</au><au>Weir, Patricia</au><au>Wolf, Andrew</au><au>Marks, David I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The outcome of children requiring admission to an intensive care unit following bone marrow transplantation</atitle><jtitle>British journal of haematology</jtitle><addtitle>Br J Haematol</addtitle><date>1998-08</date><risdate>1998</risdate><volume>102</volume><issue>3</issue><spage>666</spage><epage>670</epage><pages>666-670</pages><issn>0007-1048</issn><eissn>1365-2141</eissn><coden>BJHEAL</coden><abstract>We report the results of a retrospective study of the role of intensive care unit (ICU) admission in the management of 367 children who underwent bone marrow transplantation (BMT) at a tertiary referral institution. 39 patients (11%) required 44 ICU admissions for a median of 6 d. 70% received marrow from unrelated donors, half of which were mismatched; 80% had leukaemia and two‐thirds were considered high‐risk transplants. Respiratory failure was the major reason for admission to ICU. 75% of admissions required mechanical ventilation (for a median of 5 d) and 20 patients had lung injury as defined by the criteria of the Seattle group. None of 11 patients with proven viral pneumonitis survived (P = 0.06) and only one of 20 patients with lung injury survived (P < 0.01). Six of seven patients with a primary neurological problem survived (P < 0.001); these appear to represent a good outcome group. Age, the presence of graft‐versus‐host disease, the use of inotropes, isolated renal or hepatic impairment, and paediatric risk of mortality (PRISM) score were not predictive of outcome. In total, 12 patients (27% of admissions) survived and were discharged from hospital 30 d or more after admission and eight (18%) survived >6 months. ICU admission can be beneficial to selected children post‐BMT but it may be less useful in proven viral pneumonitis. Where mechanical ventilation is required, the duration of this support should be limited unless there is rapid improvement.</abstract><cop>Oxford, U.K. and Cambridge, USA</cop><pub>Blackwell Publishers</pub><pmid>9722291</pmid><doi>10.1046/j.1365-2141.1998.00817.x</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acute Disease Adolescent Anemia, Aplastic - therapy Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences bone marrow transplantation Bone Marrow Transplantation - mortality Child Child, Preschool children Critical Care Emergency and intensive respiratory care Female Hematology Humans Infant Intensive care medicine intensive care unit Leukemia, Myeloid - therapy Lung Diseases - etiology Lung Diseases - therapy lung injury Male mechanical ventilation Medical sciences Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy Prognosis Referral and Consultation Respiration, Artificial Retrospective Studies Risk Factors Survivors |
| title | The outcome of children requiring admission to an intensive care unit following bone marrow transplantation |
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