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

Research output: Contribution to journalArticle

59 Citations (Scopus)

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
StatePublished - Jan 1994
Externally publishedYes

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Intratracheal Intubation
Multiple Organ Failure
Bone Marrow
Pediatrics
Transplants
Artificial Respiration
Lung Diseases
Survival
Critical Care
Bone Marrow Transplantation
Respiratory Insufficiency
Population
Decision Making
Leukemia
Mortality
Transplant Recipients

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Todd, K., Wiley, F., Landaw, E., Gajewski, J., Bellamy, P. E., Harrison, R. E., ... Feig, S. A. (1994). Survival outcome among 54 intubated pediatric bone marrow transplant patients. Critical Care Medicine, 22(1), 171-176.

Survival outcome among 54 intubated pediatric bone marrow transplant patients. / Todd, K.; Wiley, F.; Landaw, E.; Gajewski, J.; Bellamy, P. E.; Harrison, R. E.; Brill, J. E.; Feig, S. A.

In: Critical Care Medicine, Vol. 22, No. 1, 01.1994, p. 171-176.

Research output: Contribution to journalArticle

Todd, K, Wiley, F, Landaw, E, Gajewski, J, Bellamy, PE, Harrison, RE, Brill, JE & Feig, SA 1994, 'Survival outcome among 54 intubated pediatric bone marrow transplant patients.', Critical Care Medicine, vol. 22, no. 1, pp. 171-176.
Todd K, Wiley F, Landaw E, Gajewski J, Bellamy PE, Harrison RE et al. Survival outcome among 54 intubated pediatric bone marrow transplant patients. Critical Care Medicine. 1994 Jan;22(1):171-176.
Todd, K. ; Wiley, F. ; Landaw, E. ; Gajewski, J. ; Bellamy, P. E. ; Harrison, R. E. ; Brill, J. E. ; Feig, S. A. / Survival outcome among 54 intubated pediatric bone marrow transplant patients. In: Critical Care Medicine. 1994 ; Vol. 22, No. 1. pp. 171-176.
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