Journal of the Korean Pediatric Society 2002;45(8):1000-1006.
Published online August 15, 2002.
Analysis of Etiology and Prognosis of Pulmonary Complications in Children with Hematological or Oncological Disorders in Pediatric Intensive Care Unit
Jin Young Jung, Soo-Jong Hong, Young Jun An, Ja Hyung Kim, Jong Jin Seo, Hyung Nam Moon, Thad Ghim
Department of Pediatrics, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea
소아 중환자실에 입원한 혈액-종양 환아에서 발생한 폐 합병증의 원인과 예후에 대한 분석
정진영, 홍수종, 안영준, 김자형, 서종진, 문형남, 김태형
울산대학교 의과대학 서울아산병원 소아과
Correspondence: 
Soo-Jong Hong, Email: sjhong@amc.seoul.kr
Abstract
Purpose
: In the course of treatment, patients with hematological or oncological disorders often develop pulmonary complication. The patients who develop a severe pulmonary complication have a poor outlook. The causes of pulmonary complication are either infectious or non-infectious in origin. We have analyzed the etiology and outcome of these patients admitted to the pediatric intensive care unit of Asan Medical Center.
Methods
: Medical records of 95 patients on Pediatric oncology service who were admitted to pediatric intensive care unit(PICU) of Asan Medical Center from Jan 1997 to May 2000 were retrospectively reviewed.
Results
: The mean age of the patients was 8.5 years(2 months-18 years). The underlying malignancies of these 95 patients were as following; acute lymphoblastic leukemia(31 cases), lymphoma (11 cases), acute myeloid leukemia(nine cases), brain tumor(eight cases) and other solid tumors(25 cases). Pulmonary complications included pneumonia, acute respiratory failure, pneumothorax and pleural effusion. The most common cause of pulmonary complication was infection(88%) in etiology. The overall mortality rate was 56.8%. Pulmonary complications in these patients carried high rates of mortality regardless of whether they were immune compromised(76%) or not(69%). Even without pulmonary complications, the hematological or oncological patients admitted to PICU had high mortality rates of 43%.
Conclusion
: Pulmonary complications are frequent finding in the hematological or oncological patients admitted to Intensive Care Unit. The main etiology of these pulmonary complications was infection, which carried a high mortality rate regardless of their immune status at the time when they were admitted to PICU.
Key Words: Hematological or oncological malignant patients, Pulmonary complication, Pediatric intensive care unit


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