OBJECTIVE: To investigate pediatric intensive care unit (PICU) admission in children with malignant and nonmalignant diseases who developed life-threatening complications. PATIENTS AND METHODS: Between 1999 and 2010, of the 1278 eligible pediatric patients treated for a malignant or nonmalignant disease, 54 were admitted to the PICU for respiratory distress (40.7%), neurological events (33.3%), severe sepsis (14.8%), and organ failure (11.2%). RESULTS: Rate of PICU admission was 4.2%, with a 2-year cumulative incidence of 4.5%. Risk factors associated with higher cumulative incidence of PICU admission were older age at study entry (P=0.003), nonmalignant underlying disease (P=0.015), and hematopoietic stem cell transplantation (P<0.001). Patients with leukemia/lymphoma were more likely to be admitted to the PICU compared with patients with solid tumors (P<0.001). Patients admitted because of organ failure had the highest frequency of death within 90 days. Factors significantly associated with survival at 90 days from PICU admission included: no mechanical ventilation (P<0.001), nonmalignant underlying disease (P=0.030), and year of PICU admission after 2005 (P=0.038). CONCLUSIONS: Nonmalignant disease and use of alternative hematopoietic stem cell transplantation were associated with higher risk of PICU admission. Close cooperation between hematologists and intensivists and definition of criteria for PICU admission and discharge contributed to increase in survival of these patients.
OBJECTIVE: To investigate pediatric intensive care unit (PICU) admission in children with malignant and nonmalignant diseases who developed life-threatening complications. PATIENTS AND METHODS: Between 1999 and 2010, of the 1278 eligible pediatric patients treated for a malignant or nonmalignant disease, 54 were admitted to the PICU for respiratory distress (40.7%), neurological events (33.3%), severe sepsis (14.8%), and organ failure (11.2%). RESULTS: Rate of PICU admission was 4.2%, with a 2-year cumulative incidence of 4.5%. Risk factors associated with higher cumulative incidence of PICU admission were older age at study entry (P=0.003), nonmalignant underlying disease (P=0.015), and hematopoietic stem cell transplantation (P<0.001). Patients with leukemia/lymphoma were more likely to be admitted to the PICU compared with patients with solid tumors (P<0.001). Patients admitted because of organ failure had the highest frequency of death within 90 days. Factors significantly associated with survival at 90 days from PICU admission included: no mechanical ventilation (P<0.001), nonmalignant underlying disease (P=0.030), and year of PICU admission after 2005 (P=0.038). CONCLUSIONS:Nonmalignant disease and use of alternative hematopoietic stem cell transplantation were associated with higher risk of PICU admission. Close cooperation between hematologists and intensivists and definition of criteria for PICU admission and discharge contributed to increase in survival of these patients.
Authors: Robert B Lindell; Shira J Gertz; Courtney M Rowan; Jennifer McArthur; Florian Beske; Adrian Plunkett; Scott L Weiss; Neal J Thomas; Vinay M Nadkarni; Julie C Fitzgerald Journal: Pediatr Crit Care Med Date: 2017-12 Impact factor: 3.624
Authors: Matt S Zinter; Brent R Logan; Caitrin Fretham; Anil Sapru; Allistair Abraham; Mahmoud D Aljurf; Staci D Arnold; Andrew Artz; Jeffery J Auletta; Saurabh Chhabra; Edward Copelan; Christine Duncan; Robert P Gale; Eva Guinan; Peiman Hematti; Amy K Keating; David I Marks; Richard Olsson; Bipin N Savani; Celalettin Ustun; Kirsten M Williams; Marcelo C Pasquini; Christopher C Dvorak Journal: Biol Blood Marrow Transplant Date: 2019-09-26 Impact factor: 5.742
Authors: Robert B Lindell; Akira Nishisaki; Scott L Weiss; Danielle M Traynor; Julie C Fitzgerald Journal: Crit Care Med Date: 2020-07 Impact factor: 7.598