Analysis of Etiology and Prognosis of Pulmonary Complications in Children with Hematological or Oncological Disorders in Pediatric Intensive Care Unit.
- Author:
Jin Young JUNG
1
;
Soo Jong HONG
;
Young Jun AN
;
Ja Hyung KIM
;
Jong Jin SEO
;
Hyung Nam MOON
;
Thad T GHIM
Author Information
1. Department of Pediatrics, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea. sjhong@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Hematological or oncological malignant patients;
Pulmonary complication;
Pediatric intensive care unit
- MeSH:
Brain;
Child*;
Chungcheongnam-do;
Humans;
Intensive Care Units*;
Critical Care*;
Lymphoma;
Medical Records;
Mortality;
Pleural Effusion;
Pneumonia;
Pneumothorax;
Prognosis*;
Respiratory Insufficiency;
Retrospective Studies
- From:Journal of the Korean Pediatric Society
2002;45(8):1000-1006
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: In the course of treatment, patients with hematological or oncological disorders often develop pulmonary complication. The patients who develop a severe pulmonary complication have a poor outlook. The causes of pulmonary complication are either infectious or non-infectious in origin. We have analyzed the etiology and outcome of these patients admitted to the pediatric intensive care unit of Asan Medical Center. METHODS: Medical records of 95 patients on Pediatric oncology service who were admitted to pediatric intensive care unit(PICU) of Asan Medical Center from Jan 1997 to May 2000 were retrospectively reviewed. RESULTS: The mean age of the patients was 8.5 years(2 months-18 years). The underlying malignancies of these 95 patients were as following; acute lymphoblastic leukemia(31 cases), lymphoma (11 cases), acute myeloid leukemia(nine cases), brain tumor(eight cases) and other solid tumors(25 cases). Pulmonary complications included pneumonia, acute respiratory failure, pneumothorax and pleural effusion. The most common cause of pulmonary complication was infection(88%) in etiology. The overall mortality rate was 56.8%. Pulmonary complications in these patients carried high rates of mortality regardless of whether they were immune compromised(76%) or not(69%). Even without pulmonary complications, the hematological or oncological patients admitted to PICU had high mortality rates of 43%. CONCLUSION: Pulmonary complications are frequent finding in the hematological or oncological patients admitted to Intensive Care Unit. The main etiology of these pulmonary complications was infection, which carried a high mortality rate regardless of their immune status at the time when they were admitted to PICU
