Incidence, risk factors, and outcome of transfusion-related acute lung injury in critically ill children: a retrospective study.

Autor: Mulder HD; Department of Pediatric Intensive Care, Emma Children's Hospital/Academic Medical Centre, Amsterdam, the Netherlands., Augustijn QJ; Department of Pediatric Intensive Care, Emma Children's Hospital/Academic Medical Centre, Amsterdam, the Netherlands., van Woensel JB; Department of Pediatric Intensive Care, Emma Children's Hospital/Academic Medical Centre, Amsterdam, the Netherlands., Bos AP; Department of Pediatric Intensive Care, Emma Children's Hospital/Academic Medical Centre, Amsterdam, the Netherlands., Juffermans NP; Department of Intensive Care, Academic Medical Centre, Amsterdam, the Netherlands., Wösten-van Asperen RM; Department of Pediatric Intensive Care, Emma Children's Hospital/Academic Medical Centre, Amsterdam, the Netherlands. Electronic address: r.m.vansperen@amc.uva.nl.
Jazyk: angličtina
Zdroj: Journal of critical care [J Crit Care] 2015 Feb; Vol. 30 (1), pp. 55-9. Date of Electronic Publication: 2014 Oct 08.
DOI: 10.1016/j.jcrc.2014.10.005
Abstrakt: Purpose: Acute lung injury (ALI) that develops within 6 hours after transfusion (TRALI) is the leading cause of transfusion-related morbidity and mortality. Both incidence and patient and transfusion-related risk factors are well studied in the adult critically ill patient population. Clinical data on TRALI in the pediatric population are sparse and are mainly limited to case reports and hemovigilance reporting systems. The objective of this study was to determine incidence, risk factors, and outcome of TRALI in critically ill children.
Materials and Methods: In a retrospective cohort study, all first-time admissions to the pediatric intensive care unit from January 1, 2009, until December 31, 2012, were screened for onset of TRALI using the consensus criteria.
Results: Of 2294 admitted patients, 304 were transfused, of whom 21 (6.9%) developed TRALI. Compared with transfused control subjects, risk factors for TRALI were mechanical ventilation (odds ratio, 18.94 [2.38-2452.56]), sepsis (odds ratio, 7.20 [2.69-19.69]), and high Pediatric Risk of Mortality III score (odds ratio, 1.05 [1.01-1.10]). Patients with TRALI had a higher mortality and a longer duration of mechanical ventilation when compared with transfused control subjects.
Conclusions: Transfusion-related ALI is relatively common in critically ill children. The incidence in the pediatric intensive care unit population is similar to that in adult intensive care unit patients. High PRISM score on admission, mechanical ventilation and sepsis were identified as independent risk factors, which may help to assess the risks and benefits of transfusion in critically ill patients.
(Copyright © 2014 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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