Transfer of the hematopoietic stem cell transplant patient to the intensive care unit: does it really matter?

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

“…3,11,12 Furthermore, it has also been suggested that an earlier transfer to the PICU might contribute to improved outcomes among these patients. 3,13 Data suggesting that admission rates for HSCT patients have risen since the year 2000, 5 in conjunction with data showing that fewer HSCT patients have required mechanical ventilation since that time, support that trend in care. 6 Data obtained through the survey also suggest that there is variation in the approach to pediatric HSCT patients when they become critically ill.…”

“…[2][3][4] Respiratory failure, secondary to pulmonary complications, is the most frequent reason for PICU admission, accounting for 35-88% of transfers. 2,4,5 Although debated, 6 several recent studies suggest improved survival over time in ventilated HSCT children with survival rates exceeding 50% being reported. 3,7,8 The reasons for this improvement have not been clearly established and are likely multifactorial.…”

Sequential Organ Failure Assessment predicts the outcome of SCT recipients admitted to intensive care unit

“…Most common are patients requiring mechanical ventilation, multiorgan failure and shock. 1 Despite the poor prognosis, survival after ICU care has been reported. [2][3][4] Since 1998, the survival of ASCT patients treated in the ICU has improved, probably attributed to improvements in ASCT treatment, patient selection and ICU management.…”

“…[2][3][4] Since 1998, the survival of ASCT patients treated in the ICU has improved, probably attributed to improvements in ASCT treatment, patient selection and ICU management. 1 At the ICU, more sophisticated ventilation strategies have been developed, 5 such as invasive and noninvasive ventilation (NIV), and early goal-directed therapy (EGDT). 6 The latter means that patients should be stabilized to normal physiological level as soon as possible at the ICU.…”

Critically ill allogeneic hematopoietic stem cell transplantation patients in the intensive care unit: reappraisal of actual prognosis

“…6 Still, allo-HSCT remains associated with significant mortality and a significant number of patients require intensive care unit (ICU) management because of life-threatening complications. 7 Intensivists will be increasingly asked to manage these patients given the growing incidence of hematological malignancies.…”