title: Respiratory Failure in Children With Hemato-oncological Diseases Admitted to the PICU: A Single-center Experience.
abstract: Respiratory failure (RF) is a main cause of pediatric intensive care unit (PICU) admission in children with hemato-oncological diseases. We present a retrospective chart review of children admitted to our PICU because of RF (January 2006 to December 2010). The aims of this study are the following: (1) to describe the demographical and clinical characteristics and respiratory management of these children; and (2) to identify the factors associated with mechanical ventilation (MV) and mortality. A total of 69 patients, encompassing 88 episodes, were included (55/88 cases were hypoxemic RF). The first respiratory support at PICU admission was, in decreasing order of frequency, high-flow oxygen nasal cannula (HFNC; 50/88), noninvasive ventilation (NIV; 13/88), and oxygen nasal cannula (16/88). MV was necessary in 47/88 episodes, 38/47 after another respiratory support. In 18/28 children with initial NIV, MV was required later. MV was associated with O-PRISM score, NIV requirement, suspected respiratory infection, and days of PICU treatment. Patients without MV showed an increased survival rate (P=0.001). In summary, the hypoxemic RF was the main cause of PICU admission, and HFNC or NIV was almost always the first respiratory support. The use of MV was associated with a higher mortality rate. The utility of precocious HFNC or NIV should be investigated in larger clinical studies.
authors.affiliation: Pediatric Critical Care Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: García-Salido
authors.forename: Ignacio
authors.initials: I
authors.lastname: Mastro-Martínez
authors.forename: Beatriz
authors.initials: B
authors.lastname: Cabeza-Martín
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Oñoro
authors.forename: Montserrat
authors.initials: M
authors.lastname: Nieto-Moro
authors.forename: María I
authors.initials: MI
authors.lastname: Iglesias-Bouzas
authors.forename: Ana
authors.initials: A
authors.lastname: Serrano-González
authors.forename: Juan
authors.initials: J
authors.lastname: Casado-Flores
mesh_terms: D002648:Child; D005260:Female; D005500:Follow-Up Studies; D019337:Hematologic Neoplasms / Q000150:complications*; D006760:Hospitalization; D006801:Humans; D015278:Intensive Care Units, Pediatric; D008297:Male; D011379:Prognosis; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D015996:Survival Rate