Introduction of sodium pentosan polysulfate and avoidance of urethral catheterisation: improved outcomes in children with haemorrhagic cystitis post stem cell transplant/chemotherapy
| Autor: | Mark Velangi, Lisa Whyte, Gillian Duthie, Harish Chandran, Liam McCarthy, Sarah Lawson |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Blood transfusion Adolescent Cyclophosphamide medicine.medical_treatment Hematopoietic stem cell transplantation Urinary catheterization Immunocompromised Host Postoperative Complications Antineoplastic Combined Chemotherapy Protocols Cystitis medicine Humans Prospective Studies Child Prospective cohort study Hematuria Mesna Ultrasonography Pentosan Sulfuric Polyester Polyomavirus Infections Leukemia business.industry Hematopoietic Stem Cell Transplantation Herpesviridae Infections General Medicine Combined Modality Therapy Surgery Catheter Exact test Fanconi Anemia BK Virus Pediatrics Perinatology and Child Health Female Urinary Catheterization business Complication medicine.drug |
| Zdroj: | Journal of Pediatric Surgery. 47:375-379 |
| ISSN: | 0022-3468 |
| Popis: | Haemorrhagic cystitis (HC) is an uncommon but potentially devastating complication of chemotherapy and bone marrow transplantation in children. We aimed to test the hypothesis that early recognition, sodium pentosan polysulfate (SPP), and avoidance of urethral catheterisation improve outcomes in children with HC.A retrospective case note review was performed of all patients treated for HC in our hospital from 2002 to 2010. A protocol for the management of HC was introduced in 2007 advocating early detection, use of SPP, and avoidance of urethral catheterisation. Data collected on each patient included primary condition, medications at onset, blood transfusions, duration of symptoms, catheter usage, and outcome. Statistical analysis was performed using the Mann-Whitney U test, and Fisher's Exact test as appropriate, P.05 being significant.Five patients were treated using protocol with 5 historical controls. There was no significant difference between the ages of the group, diagnosis, and treatment at onset of HC. In the historical group, 4 of 5 died with HC, but all recovered in the protocol group (P.05). Blood transfusion requirements were also significantly reduced after protocol introduction (P.05).Early identification, avoidance of urethral catheterisation, and use of SPP significantly reduces blood transfusion requirements and mortality from HC. |
| Databáze: | OpenAIRE |
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