Outcome of Children Requiring Intensive Care Following Hematopoietic Stem Cell Transplantation: A Single Center Experience

造血干细胞移植后需重症监护患儿的预后:单中心经验

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Abstract

Hematopoietic stem cell transplant (HSCT) is associated with some complications requiring advanced support in the pediatric intensive care unit (PICU). However, the outcome of children requiring admission to a PICU following HSCT in middle-income countries (MICs) are limited. One hundred and four children undergoing hematopoietic stem cell transplantation at a bone marrow transplant service in Colombia from January 2012 to June 2019 were enrolled. Baseline characteristics and clinical courses were described. In addition, we compared some characteristics of patients who survived or died in the PICU through a bivariate analysis. Twenty five PICU admissions were reported. Sixty-four percent survived to be discharged from any PICU admission. Immunodeficiency was the most common underlying disease among patients admitted to the PICU (33%). Respiratory problems (12/25, 48%), and cardiovascular instability (10/25, 40%) were the most common reasons for admission. Cardiovascular support was the most common PICU treatment (21/25, 84%), followed by respiratory support (18/25, 72%). We found that children who require admission to PICU after an allogeneic hematopoietic stem-cell transplantation (Allo-HSCT) present a high mortality rate. Invasive respiratory support, higher vasoactive-inotropic score, renal replacement therapy, and the presence of multi-organ failure were associated with mortality.

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