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pubmed-article:9827977pubmed:abstractTextBetween 1976 and 1992, 869 patients <19 years of age underwent BMT at the University of Minnesota for a variety of malignant and non-malignant disorders. One hundred and ninety-six required mechanical ventilation (MV) at some time from the start of pre-BMT cyto reduction through the first year following BMT. Reasons for MV included respiratory compromise, upper airway management and non-pulmonary indications for respiratory support. In multivariate models, underlying diagnosis, receipt of HLA-mismatched marrow and the presence of acute graft-versus-host disease (aGVHD) were independent predictors of the need for MV. Indication for MV, underlying diagnosis, and presence of aGVHD were independent predictors of successful extubation. Overall survival at 2 years was 14% among MV patients and 52% among non-MV patients. While the need for MV during BMT reduces the overall likelihood of survival, 40% of children who required MV were successfully extubated; 35% of these extubated patients were long-term survivors. This outcome is better than that reported for adult BMT patients requiring respiratory support, who show survival of <5% at 6 months following BMT. Our data suggest extrapolation of outcome data from adult to pediatric patients is not appropriate and aggressive care of pediatric patients requiring respiratory support is not futile.lld:pubmed
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pubmed-article:9827977pubmed:authorpubmed-author:RamsayN KNKlld:pubmed
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pubmed-article:9827977pubmed:authorpubmed-author:NegliaJ PJPlld:pubmed
pubmed-article:9827977pubmed:authorpubmed-author:MertensA CAClld:pubmed
pubmed-article:9827977pubmed:authorpubmed-author:WarwickA BABlld:pubmed
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pubmed-article:9827977pubmed:pagination787-94lld:pubmed
pubmed-article:9827977pubmed:dateRevised2007-11-14lld:pubmed
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pubmed-article:9827977pubmed:articleTitleOutcomes following mechanical ventilation in children undergoing bone marrow transplantation.lld:pubmed
pubmed-article:9827977pubmed:affiliationDepartment of Pediatrics, Medical College of Wisconsin, Milwaukee 53226, USA.lld:pubmed
pubmed-article:9827977pubmed:publicationTypeJournal Articlelld:pubmed
pubmed-article:9827977pubmed:publicationTypeResearch Support, U.S. Gov't, P.H.S.lld:pubmed
pubmed-article:9827977pubmed:publicationTypeResearch Support, Non-U.S. Gov'tlld:pubmed