Inconsistencies in care of the pediatric hematopoietic stem cell transplant recipient with respiratory failure: Opportunity for standardization and improved outcome

Courtney M. Rowan, Mara Nitu, Mark R. Rigby

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

There is variability in critical care outcome of the HSCT recipient. One potential reason may be due to the inconsistent ventilation approaches. To quantitate this variability, we conducted a survey to assess self-reported use of ventilation and adjunctive strategies for the HSCT recipient. Electronic survey, open from June 2012 through January 201, distributed through the Pediatric Acute Lung Injury and Sepsis Investigators network electronic mailing list. Ninety-four individual responses were from 36 different institutions. The majority indicated that HSCT recipients requiring critical care were admitted to the general PICU. The vast majority (89%) endorsed routine practice of low-tidal-volume ventilation strategies. More than half stated that pressure-regulated volume control is the starting mode of choice. Eighty-three percent felt their group practiced early initiation of lung protective strategies. Eleven percent encouraged "early transition" to HFOV. Inhaled nitric oxide and milrinone were reported at the highest frequencies, but the majority used these empirically. Opinions regarding variables that affect outcomes of the HSCT were diverse. The estimated mortality of HSCT patients with respiratory was highly variable. Strategies for ventilation and oxygenation, use of HFOV, and adjunctive therapies are variable among pediatric intensivists.

Original languageEnglish
Pages (from-to)230-235
Number of pages6
JournalPediatric Transplantation
Volume18
Issue number2
DOIs
StatePublished - Mar 2014

Fingerprint

Hematopoietic Stem Cells
Respiratory Insufficiency
Ventilation
Pediatrics
Transplants
Milrinone
Acute Lung Injury
Tidal Volume
Critical Care
Sepsis
Nitric Oxide
Research Personnel
Pressure
Lung
Mortality
Transplant Recipients
Surveys and Questionnaires
Therapeutics

Keywords

  • clinical protocols
  • hematopoietic stem cell transplantation
  • high-frequency ventilation
  • oxygen inhalation therapy
  • pediatrics
  • pulmonary ventilation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation
  • Medicine(all)

Cite this

@article{81e2e7f6d5574c8c913ef98c093339a3,
title = "Inconsistencies in care of the pediatric hematopoietic stem cell transplant recipient with respiratory failure: Opportunity for standardization and improved outcome",
abstract = "There is variability in critical care outcome of the HSCT recipient. One potential reason may be due to the inconsistent ventilation approaches. To quantitate this variability, we conducted a survey to assess self-reported use of ventilation and adjunctive strategies for the HSCT recipient. Electronic survey, open from June 2012 through January 201, distributed through the Pediatric Acute Lung Injury and Sepsis Investigators network electronic mailing list. Ninety-four individual responses were from 36 different institutions. The majority indicated that HSCT recipients requiring critical care were admitted to the general PICU. The vast majority (89{\%}) endorsed routine practice of low-tidal-volume ventilation strategies. More than half stated that pressure-regulated volume control is the starting mode of choice. Eighty-three percent felt their group practiced early initiation of lung protective strategies. Eleven percent encouraged {"}early transition{"} to HFOV. Inhaled nitric oxide and milrinone were reported at the highest frequencies, but the majority used these empirically. Opinions regarding variables that affect outcomes of the HSCT were diverse. The estimated mortality of HSCT patients with respiratory was highly variable. Strategies for ventilation and oxygenation, use of HFOV, and adjunctive therapies are variable among pediatric intensivists.",
keywords = "clinical protocols, hematopoietic stem cell transplantation, high-frequency ventilation, oxygen inhalation therapy, pediatrics, pulmonary ventilation",
author = "Rowan, {Courtney M.} and Mara Nitu and Rigby, {Mark R.}",
year = "2014",
month = "3",
doi = "10.1111/petr.12222",
language = "English",
volume = "18",
pages = "230--235",
journal = "Pediatric Transplantation",
issn = "1397-3142",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Inconsistencies in care of the pediatric hematopoietic stem cell transplant recipient with respiratory failure

T2 - Opportunity for standardization and improved outcome

AU - Rowan, Courtney M.

AU - Nitu, Mara

AU - Rigby, Mark R.

PY - 2014/3

Y1 - 2014/3

N2 - There is variability in critical care outcome of the HSCT recipient. One potential reason may be due to the inconsistent ventilation approaches. To quantitate this variability, we conducted a survey to assess self-reported use of ventilation and adjunctive strategies for the HSCT recipient. Electronic survey, open from June 2012 through January 201, distributed through the Pediatric Acute Lung Injury and Sepsis Investigators network electronic mailing list. Ninety-four individual responses were from 36 different institutions. The majority indicated that HSCT recipients requiring critical care were admitted to the general PICU. The vast majority (89%) endorsed routine practice of low-tidal-volume ventilation strategies. More than half stated that pressure-regulated volume control is the starting mode of choice. Eighty-three percent felt their group practiced early initiation of lung protective strategies. Eleven percent encouraged "early transition" to HFOV. Inhaled nitric oxide and milrinone were reported at the highest frequencies, but the majority used these empirically. Opinions regarding variables that affect outcomes of the HSCT were diverse. The estimated mortality of HSCT patients with respiratory was highly variable. Strategies for ventilation and oxygenation, use of HFOV, and adjunctive therapies are variable among pediatric intensivists.

AB - There is variability in critical care outcome of the HSCT recipient. One potential reason may be due to the inconsistent ventilation approaches. To quantitate this variability, we conducted a survey to assess self-reported use of ventilation and adjunctive strategies for the HSCT recipient. Electronic survey, open from June 2012 through January 201, distributed through the Pediatric Acute Lung Injury and Sepsis Investigators network electronic mailing list. Ninety-four individual responses were from 36 different institutions. The majority indicated that HSCT recipients requiring critical care were admitted to the general PICU. The vast majority (89%) endorsed routine practice of low-tidal-volume ventilation strategies. More than half stated that pressure-regulated volume control is the starting mode of choice. Eighty-three percent felt their group practiced early initiation of lung protective strategies. Eleven percent encouraged "early transition" to HFOV. Inhaled nitric oxide and milrinone were reported at the highest frequencies, but the majority used these empirically. Opinions regarding variables that affect outcomes of the HSCT were diverse. The estimated mortality of HSCT patients with respiratory was highly variable. Strategies for ventilation and oxygenation, use of HFOV, and adjunctive therapies are variable among pediatric intensivists.

KW - clinical protocols

KW - hematopoietic stem cell transplantation

KW - high-frequency ventilation

KW - oxygen inhalation therapy

KW - pediatrics

KW - pulmonary ventilation

UR - http://www.scopus.com/inward/record.url?scp=84893870758&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84893870758&partnerID=8YFLogxK

U2 - 10.1111/petr.12222

DO - 10.1111/petr.12222

M3 - Article

C2 - 24410896

AN - SCOPUS:84893870758

VL - 18

SP - 230

EP - 235

JO - Pediatric Transplantation

JF - Pediatric Transplantation

SN - 1397-3142

IS - 2

ER -