• Yogi Chopra, Amal Alsabahi, Tal Schechter, Haifa Mtaweh, Neil Sweezey, Corinne Balit, Muhammad Ali, Kuang-Yueh Chiang, Adam Gassas, and Joerg Krueger.
• Department of Hematology, Oncology, Blood and Marrow Transplant and Cellular Therapy, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
• Pediatr Crit Care Me. 2024 Jan 1; 25 (1): e47e51e47-e51.

ObjectivesPulmonary hemorrhage (PH) is a serious complication posthematopoietic stem cell transplant (HSCT). In view of limited available pediatric data, we performed a retrospective study to describe epidemiology, management, and outcomes of PH post-HSCT in children in our national center.DesignRetrospective study.SettingAcademic children's hospital (2000-2015).SubjectsChildren (< 18 yr) with PH and requiring PICU care post-HSCT.InterventionsNone.Measurements And Main ResultsThe historical prevalence of PH in our center was 2.7% (31/1,148). Twenty patients had a concomitant infection, 15 had bacterial infection, 8 had viral infection, and 3 patients had a fungal infection. With a median follow-up time of 60 months, 7 of 31 patients were alive. Early PH (< 40 d post-HSCT) was associated with improved survival (6/15 vs 1/16, p = 0.035). Patients who received high-dose pulsed corticosteroid had improved survival when compared with those who did not (7/22 vs 0/9, p = 0.0012); this also applied to the subgroup of patients with a concomitant infection (5/15 vs 0, p = 0.001). None of the patients who survived had measurable respiratory sequelae.ConclusionsPH is a rare but serious complication after HSCT. Corticosteroids were associated with improved survival even in patients with a concomitant infection.Copyright © 2023 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

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