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Outcome of invasive mechanical ventilation after pediatric allogeneic hematopoietic SCT: results from a prospective, multicenter registry
JP. van Gestel, MB. Bierings, S. Dauger, JH. Dalle, P. Pavlíček, P. Sedláček, LM. Monteiro, A. Lankester, CW. Bollen,
Language English Country England, Great Britain
Document type Journal Article, Multicenter Study
NLK
Free Medical Journals
from 1997 to 1 year ago
Freely Accessible Science Journals
from 1997 to 1 year ago
ProQuest Central
from 1997-01-01 to 1 year ago
Open Access Digital Library
from 1997-01-01
Medline Complete (EBSCOhost)
from 1997-01-01 to 2015-11-30
Health & Medicine (ProQuest)
from 1997-01-01 to 1 year ago
PubMed
25068426
DOI
10.1038/bmt.2014.147
Knihovny.cz E-resources
- MeSH
- Child MeSH
- Transplantation, Homologous methods mortality MeSH
- Infant MeSH
- Humans MeSH
- Adolescent MeSH
- Child, Preschool MeSH
- Transplantation Conditioning methods mortality MeSH
- Prognosis MeSH
- Prospective Studies MeSH
- Risk Factors MeSH
- Hematopoietic Stem Cell Transplantation methods mortality MeSH
- Respiration, Artificial methods MeSH
- Treatment Outcome MeSH
- Check Tag
- Child MeSH
- Infant MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
Exact data on prognosis of children receiving invasive mechanical ventilation (IMV) after allogeneic hematopoietic SCT (HSCT) is lacking. We therefore started a prospective registry in four European university HSCT centers (Leiden, Paris, Prague and Utrecht) and their pediatric intensive care units (PICUs). The registry started in January 2009. In January 2013, the four centers together had treated a total of 83 admissions with IMV. The case fatality rate in these patients was 52%. Mortality 6 months after PICU discharge was 45%. There were significant differences between centers in the proportion of children who received IMV after HSCT (6-23%, P<0.01), in severity of disease on admission to PICU (predicted mortality 14-37%, P<0.01), in applying noninvasive ventilation before IMV (3-75% of admissions, P<0.01) and in the use of renal replacement therapy (RRT) (8-58% of admissions, P<0.01). Severe impairment in oxygenation, use of RRT and CMV viremia were independent predictors of mortality. Our study shows that mortality in children receiving IMV after HSCT remains high, but has clearly improved compared with older studies. Patient selection and treatment in PICU differed significantly between centers, which underscores the need to standardize and optimize the PICU admission criteria, ventilatory strategies and therapies applied in PICU.
Pediatric Intensive Care Unit Charles University Hospital Motol Prague Czech Republic
Pediatric Intensive Care Unit Leiden University Medical Center Leiden The Netherlands
References provided by Crossref.org
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