Survival outcome among 54 intubated pediatric bone marrow transplant patients.

K. Todd, F. Wiley, E. Landaw, J. Gajewski, P. E. Bellamy, R. E. Harrison, J. E. Brill, S. A. Feig

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    60 Scopus citations

    Abstract

    OBJECTIVES: To assess the outcome of children who required endotracheal intubation after bone marrow transplantation and to determine whether prognostic indicators that might assist decision-making regarding the institution of mechanical ventilation could be identified. DESIGN: Retrospective chart review. SETTING: Critical care, reverse isolation unit at a university hospital. PATIENTS: Fifty-four pediatric bone marrow transplant recipients who required endotracheal intubation. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The following variables were assessed for effect on survival: a) the presence of additional nonhematoporetic organ system failure; b) the duration of required ventilatory assistance; c) the etiology of respiratory failure; d) the presence of significant graft vs. host disease; and e) the underlying disease for which the transplant was done. Six of 54 intubated pediatric bone marrow transplant recipients were extubated and discharged from the hospital. No patient with a diagnosis of leukemia or with multiple organ system failure could be extubated or discharged from the hospital. The presence of pulmonary parenchymal disease indicated poor prognosis for survival. CONCLUSIONS: The decision to intubate a pediatric bone marrow transplant patient remains a difficult one. In this population, multiple organ system failure and primary pulmonary parenchymal disease were associated with a high mortality rate. These factors should be taken into account before and throughout the course of mechanical ventilation in this patient population.

    Original languageEnglish (US)
    Pages (from-to)171-176
    Number of pages6
    JournalCritical care medicine
    Volume22
    Issue number1
    DOIs
    StatePublished - Jan 1994

    ASJC Scopus subject areas

    • Critical Care and Intensive Care Medicine

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    Todd, K., Wiley, F., Landaw, E., Gajewski, J., Bellamy, P. E., Harrison, R. E., Brill, J. E., & Feig, S. A. (1994). Survival outcome among 54 intubated pediatric bone marrow transplant patients. Critical care medicine, 22(1), 171-176. https://doi.org/10.1097/00003246-199401000-00030