Intensive care and outcome in children undergoing haematopoietic stem cell transplantation

Abstract

Aim

To review literature data concerning treatment of procedure-related complications in the intensive care unit in children undergoing allogeneic haematopoietic stem cell transplantation with a focus on clinical results, limitations of studies, recent improvements and remaining problems.

Materials/Methods

A review of PubMed references based on evidence-based recommendations and own experience.

Results

Modern ICU care both for adults and children undergoing HSCT has improved in the last decade. However, multi-organ system failure and those requiring mechanical ventilation have the worst outcome. Within the paediatric setting the majority of children are transferred for respiratory support and pulmonary complications. Septic shock and its consequences are associated with far fewer admissions to the ICU. The role of the ICU requires constant revision as protocols and treatments change both in the HSCT unit as well as in intensive care.

Conclusions

An adequate scoring system such as an adapted O-PRISM should be developed and would lead to the possibility of multi-centre comparative data acquisition and develop future studies in this critically ill group of patients.