Oxygenation index predicts mortality in pediatric stem cell transplant recipients requiring mechanical ventilation

• Published in: Pediatric transplantation Vol. 16; no. 6; pp. 645 - 650
• Main Authors: Rowan, Courtney M., Hege, Kerry M., Speicher, Richard H., Goodman, Michael, Perkins, Susan M., Slaven, James E., Westenkirchner, David F., Haut, Paul R., Nitu, Mara E.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.09.2012; Blackwell
• Subjects: Adolescent; Biological and medical sciences; Child; Child, Preschool; Critical Care - methods; Epidemiology; Female; General aspects; hematopoietic stem cell transplant; Hematopoietic Stem Cell Transplantation - methods; Hematopoietic Stem Cell Transplantation - mortality; Hospital Mortality; Humans; Infant; intensive care; Intensive Care Units; Male; Medical sciences; oscillation; Oscillometry - methods; Oxygen - chemistry; oxygenation index; Patient Admission; pediatrics; Public health. Hygiene; Public health. Hygiene-occupational medicine; Respiration, Artificial; Retrospective Studies; ROC Curve; Sensitivity and Specificity; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; survival; Treatment Outcome; Human; Pediatrics; oxygenation index; Prognosis; intensive care; Stem cell; Mortality; Prediction; Hematopoietic cell; Index; Recipient; Artificial ventilation; Epidemiology; Survival; oscillation; Predictive factor; Oxygenation; Child; Mechanical ventilation; Hematopoietic stem cell transplantation; hematopoietic stem cell transplant
• ISSN: 1397-3142; 1399-3046
• DOI: 10.1111/j.1399-3046.2012.01745.x

Rowan CM, Hege KM, Speicher RH, Goodman M, Perkins SM, Slaven JE, Westenkirchner DF, Haut PR, Nitu ME. Oxygenation index predicts mortality in pediatric stem cell transplant recipients requiring mechanical ventilation. :  The mortality in the ICU for pediatric HSCT recipients remains high. Early pulmonary complications continue to be an obstacle to the survival. We hypothesize OI is a predictor for mortality in critically ill pediatric HSCT recipients. Retrospective review of pediatric HSCT recipients between 2002 and 2010 who required intensive care during the same hospital admission as their transplant. Twenty‐eight patients accounted for 31 ICU admissions. Twenty‐six (84%) admissions required mechanical ventilation. Ten (38%) mechanically ventilated admissions were placed on HFOV. Mortality of those mechanically ventilated was 70%. An OI ≥ 20 at any point during ventilation was associated with 94% mortality, while an OI ≥ 25 had 100% mortality. There was a significant association between maximum OI at any point during mechanical ventilation and ICU mortality, with the odds of dying increasing by 13% for each unit increase of max OI (OR = 1.13, 95% CI = 1.01–1.26, p = 0.03). An OI of 20 had a sensitivity of 0.89 and specificity of 0.83 for predicting mortality. OI has a strong association with ICU mortality among pediatric stem cell recipients.