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10.1097/PCC.0000000000000219

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suck abstract from ncbi


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pmid25068252      Pediatr+Crit+Care+Med 2014 ; 15 (7): e321-6
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  • Clinical course and outcome predictors of critically ill infants with complete DiGeorge anomaly following thymus transplantation #MMPMID25068252
  • Lee JH; Markert ML; Hornik CP; McCarthy EA; Gupton SE; Cheifetz IM; Turner DA
  • Pediatr Crit Care Med 2014[Sep]; 15 (7): e321-6 PMID25068252show ga
  • Objective: To identify risk factors for pediatric intensive care unit (PICU) admission and mortality of infants with complete DiGeorge anomaly treated with thymus transplantation. We hypothesized that age at transplantation and presence of congenital heart disease (CHD) would be risk factors for emergent PICU admission, and these factors plus development of septicemia would increase morbidity and mortality. Design: Retrospective review Setting: Academic medical-surgical PICU Patients: All infants with complete DiGeorge anomaly treated with thymus transplantation between January 1, 1993 and July 1, 2010 Interventions: None Measurements and Main Results: Seventy one infants with complete DiGeorge anomaly were consented for thymus transplantation, and 59 were transplanted. Median age at transplantation was 5.0 (range: 1.1 ? 22.1) months. After transplantation, 12/59 infants (20%) required 25 emergent PICU admissions. Seven of 12 (58%) infants survived to PICU discharge with six surviving six months post-transplantation. Forty two of 59 (71%) infants transplanted had CHD, and 9/12 (75%) who were admitted to the PICU had CHD. In 15/25 admissions (60%), intubation and mechanical ventilation were necessary. There was no difference between median ventilation-free days between infants with and without CHD (33 vs. 23 days, p = 0.544). There was also no correlation between ventilation-free days and age of transplantation (R0.17, p=0.423). Age at transplantation and presence of CHD were not associated with risk for PICU admission (OR: 0.95, 95%CI: 0.78 ? 1.15 and OR: 1.27, 95%CI: 0.30 ? 5.49, respectively) or PICU mortality (OR: 0.98, 95%CI: 0.73 ? 1.31 and OR: 0.40, 95%CI: 0.15 ? 1.07, respectively). Conclusions: Most transplanted infants did not require emergent PICU admission. Age at transplantation and presence of CHD were not associated with PICU admission or mortality.
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