Use of Drug to Raise Blood Pressure Factor in Survival of BMT Patients in ICU

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Biology of Blood and Marrow Transplantation

Volume 12, Issue 3 , March 2006, Pages 301-305

doi:10.1016/j.bbmt.2005.10.020

Copyright © 2006 American Society for Blood and Marrow

Transplantation Published by Elsevier Inc.

Clinical research

Outcome of Hematopoietic Stem Cell Transplant Recipients Admitted to

the Intensive Care Unit

K. Kewa, b, , , Coubana, b, Ward a, b, Kara

a, b and Darrell Whitea, b

aDepartment of Medicine, Dalhousie University, Halifax, Nova Scotia,

Canada

bQueen II Health Sciences Centre, Halifax, Nova Scotia,

Canada

Received 20 July 2005; accepted 24 October 2005. Available online

28 February 2006.

Abstract

Stem cell transplantation (SCT) is associated with complications that

may necessitate intensive care unit (ICU) admission. The outcome for

SCT patients requiring ICU admission has been reported to be poor. We

describe the outcome of consecutive SCT patients admitted to the ICU

at a single center.

The study was a retrospective review of all patients at the Queen

II Health Sciences Center who received an SCT between 1992

and 2001 and were subsequently admitted to the ICU. The primary

outcome was overall survival at 12 months after ICU admission. There

were 440 SCTs in the study period; 38 of these patients were admitted

to the ICU on 42 separate occasions.

The primary indication for ICU admission was respiratory failure. The

probability of survival at 12 months was 21.6% (95% CI, 8.4%-34.9%).

On multivariate analysis, the only statistically significant variable

associated with decreased 12-month survival was vasopressor use. The

probability of survival for patients receiving vasopressor support

was 5% (95% CI, 0%-14.5%) at 30 days and 0% at 12 months, whereas the

probability of survival for patients not receiving vasopressor

support was 76.5% (95% CI, 56.3%-96.6%) at 30 days and 45.8% (95% CI,

21.5%-69.9%) at 12 months.

In this 10-year review of consecutive SCT recipients requiring ICU

admission, we found that the outcome of SCT patients requiring ICU

admission may not be as poor as previously reported. However, SCT

recipients requiring vasopressor support had very poor outcomes.

These findings will be important in deciding which SCT patients may

benefit from ICU admission and care.