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Published on: May 12, 2023
[SURVIVAL OF PEDIATRIC PATIENTS WITH NON-MALIGNANT DISEASES REQUIRING HOSPITALIZATION IN THE INTENSIVE CARE UNIT
Irina Zaidman1, Ehud Even-Or1, Asaf Mandel2
1Department of Bone Marrow Transplantation and Cancer Immunotherapy, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Insights
Pediatric patients undergoing Hematopoietic Stem Cell Transplantation (HSCT) for non-malignant disorders have a low incidence of Pediatric Intensive Care Unit (PICU) admission. Survival rates are relatively high, though factors like severe neutropenia and multi-organ failure impact outcomes.
Area of Science:
- Pediatric Hematology
- Intensive Care Medicine
- Transplantation Science
Introduction:
Although Hematopoietic Stem Cell Transplantation (HSCT) is the only curative option for children with certain non-malignant disorders, a proportion of these children are admitted to the Pediatric Intensive Care Unit (PICU) due to treatment related life-threatening complications.
Aims:
To analyze risk factors for ICU hospitalizations, morbidity and mortality in children with genetic diseases who have undergone HSCT and were admitted to intensive care units.
Methods:
This retrospective study is based on the collection and analysis of clinical and laboratory data from the medical records of patients from the departments of Bone Marrow Transplantations and Intensive Care, from 2 hospitals, Hadassah and Rambam Medical Centers.
Results:
Over the course of 15 years (2005-2019), 463 HSCT were performed for pediatric patients with non-malignant diseases, 68 of them (15%) required hospitalization in Intensive Care Units (ICU), 41% of the patients survived. The PICU mortality rate has decreased over the last years. Factors found to have a significant negative impact on PICU survival were severe neutropenia at admission to ICU, mechanical ventilation, inotropic support, and Multi Organ Failure (MOF).
Conclusions:
Our results showed low incidence of ICU admissions and relatively high survival rate for pediatric patients with non-malignant disorders post HSCT, comparing with literature data.
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