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Pediatric Transplants

The care of critically ill children after hematopoietic SCT: a North American survey

Bone Marrow Transplantation volume 46, pages 227–231 (2011)Cite this article

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Abstract

Although potentially curative, hematopoietic SCT (HSCT) is associated with significant morbidity. To improve outcomes, multicenter studies of critical illness in this patient population appear needed. To assist in the design of such studies, a survey was conducted to identify variations in care provided to critically ill pediatric HSCT patients. A survey was conducted of the highest volume pediatric HSCT centers in the United States (n=30) and Canada (n=4). One pediatric critical care medicine (PCCM) physician and one pediatric HSCT physician were surveyed at each institution. Analysis consisted of descriptive statistics. Thirty-three (29 United States/4 Canada) of 34 institutions responded. Although most HSCT units permit fluid boluses and nearly half permit some dose of dopamine, high-dose dopamine and other vasoactive infusions are rarely allowed there. Six institutions (21%) permit non-invasive ventilation on the HSCT unit. Criterion for PCCM consultation and therapies implemented before intubation vary significantly. High-frequency oscillatory ventilation and renal replacement therapy are commonly used for lung injury in patients failing conventional therapy. Variability exists in the location and type of therapy critically ill pediatric HSCT patients receive. Understanding this variability will help facilitate the design of clinical trials.

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Acknowledgements

We thank all pediatric HSCT and PCCM physicians who participated in this survey.

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Authors and Affiliations

  1. Department of Pediatrics, Division of Pediatric Critical Care, Medical College of Wisconsin, Milwaukee, WI, USA

    J McArthur & M Christensen

  2. Department of Pediatrics, Centre Hospitalier Universitaire Ste-Justine, Montreal, Quebec, Canada

    G Pettersen & P Jouvet

  3. Departments of Pediatrics and Public Health Sciences, Penn State Hershey Children's Hospital, Pennsylvania State University College of Medicine, Hershey, PA, USA

    R Tamburro

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  1. J McArthur
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  2. G Pettersen
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  4. M Christensen
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  5. R Tamburro
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for the Pediatric Acute Lung Injury and Sepsis Investigators

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Correspondence to J McArthur.

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The authors declare no conflict of interest.

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Supplementary Information accompanies the paper on Bone Marrow Transplantation website ()

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McArthur, J., Pettersen, G., Jouvet, P. et al. The care of critically ill children after hematopoietic SCT: a North American survey. Bone Marrow Transplant 46, 227–231 (2011). https://doi.org/10.1038/bmt.2010.89

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