Acute and Critical Care

Original Articles

Pediatrics
Prognostic factors of pediatric hematopoietic stem cell transplantation recipients admitted to the pediatric intensive care unit: Da Hyun Kim, Eun Ju Ha, Seong Jong Park, Kyung-Nam Koh, Hyery Kim, Ho Joon Im, Won Kyoung Jhang; Acute Crit Care. 2021;36(4):380-387. Published online November 26, 2021; DOI: https://doi.org/10.4266/acc.2020.01193

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Background
Pediatric patients who received hematopoietic stem cell transplantation (HSCT) tend to have high morbidity and mortality. While, the prognostic factors of adult patients received bone marrow transplantation were already known, there is little known in pediatric pateints. This study aimed to identify the prognostic factor for pediatric intensive care unit (PICU) mortality of critically ill pediatric patients with HSCT.
Method
Retrospectively reviewed that the medical records of patients who received HSCT and admitted to PICU between January 2010 and December 2019. Mortality was defined a patient who expired within 28 days.
Results
A total of 131 patients were included. There were 63 boys (48.1%) and median age was 11 years (interquartile range, 0–20 years). The most common HSCT type was haploidentical (38.9%) and respiratory failure (44.3%) was the most common reason for PICU admission. Twenty-eight–day mortality was 22.1% (29/131). In comparison between survivors and non-survivors, the number of HSCT received, sepsis, oncological pediatric risk of mortality-III (OPRISM-III), PRISM-III, pediatric sequential organ failure assessment (pSOFA), serum lactate, B-type natriuretic peptide (BNP) and use of mechanical ventilator (MV) and vasoactive inotropics were significant predictors (p<0.05 for all variables). In multivariate logistic regression, number of HSCT received, use of MV, OPRISM-III, PRISM-III and pSOFA were independent risk factors of PICU mortality. Moreover, three scoring systems were significant prognostic factors of 28-day mortality.
Conclusions
The number of HSCT received and use of MV were more accurate predictors in pediatric patients received HSCT.

Citations

Citations to this article as recorded by

Prognostic factors and predictive scores for 6-months mortality of hematopoietic stem cell transplantation recipients admitted to the pediatric intensive care unit
Sarah Schober, Silke Huber, Norbert Braun, Michaela Döring, Peter Lang, Michael Hofbeck, Felix Neunhoeffer, Hanna Renk
Frontiers in Oncology.2023;[Epub] CrossRef
Survival outcomes of pediatric hematopoietic stem cell transplant patients admitted to the intensive care unit: A case–control study from a tertiary care center in Saudi Arabia
LujainTalib Aljudaibi, MohamedSalaheldin Bayoumy, HassanA Altrabolsi, AbdullahM Alzaydi, Nawaf Aldajani, Nadia Hammad, Ismail Alzahrani, Marwa Elhadidy, IbraheemF Abosoudah
Journal of Applied Hematology.2022; 13(4): 192. CrossRef

Low Blood Selenium Concentrations in Critically Ill Children with Systemic Inflammatory Response Syndrome and Respiratory Dysfunction: Young A Kim, Eun Ju Ha, Won Kyoung Jhang, Seong Jong Park; Korean J Crit Care Med. 2013;28(2):86-92.; DOI: https://doi.org/10.4266/kjccm.2013.28.2.86

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Abstract PDF: BACKGROUND
Selenium is an essential trace-element with antioxidant and immunological function. We studied the relationship between blood selenium concentrations, systemic inflammatory response syndrome (SIRS) and organ dysfunctions in critically ill children.
METHODS
This was a retrospective, observational study of the blood selenium concentrations of critically ill children at the time of a pediatric intensive care unit admission.
RESULTS
A total of 62 patients with a median age of 18 (5-180) months were included in this study. The mean of blood selenium concentration (microg/dl) was 8.49 +/- 2.42. The platelet count (r = -0.378) and PaCO2 (r = -0.403) showed negative correlations with blood selenium concentration, while PaO2/FiO2 (r = 0.359) and PaO2 (r = 0.355) showed positive correlations (p < 0.05, for all variables). Blood selenium concentrations were significantly lower in patients with SIRS than in those patients without SIRS (8.08 +/- 2.42 vs. 9.45 +/- 2.02, p = 0.011). Patients with severe sepsis and septic shock had showed significantly lower blood selenium concentrations than those without SIRS (7.03 +/- 2.73 vs. 9.45 +/- 2.02, p = 0.042). Patients with PaO2/FiO2 < or = 300 had lower blood selenium concentrations than those with PaO2/FiO2 > 300 (7.90 +/- 2.43 vs. 9.54 +/- 2.17, p = 0.018). Blood selenium concentrations were significantly lower in patient with PaO2/FiO2 < or = 200 than in those with PaO2/FiO2 > 300 (7.64 +/- 2.76 vs. 9.54 +/- 2.17, p = 0.018).
CONCLUSIONS
Patients with systemic inflammatory response syndrome or respiratory dysfunction showed significantly low blood selenium concentrations.

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