• Maura Faraci, Francesca Bagnasco, Stefano Giardino, Massimo Conte, Concetta Micalizzi, Elio Castagnola, Elisabetta Lampugnani, Andrea Moscatelli, Alessia Franceschi, Joseph A Carcillo, and Riccardo Haupt.
• *Hematology-Oncology Department-Stem Cell Transplantation Section †Epidemiology and Biostatistics Section, Scientific Directorate ‡Infectious Diseases Unit §Neonatal and Pediatric Intensive Care Unit, G. Gaslini Research Institute, Genoa, Italy ∥Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
• J. Pediatr. Hematol. Oncol. 2014 Oct 1;36(7):e403-9.

ObjectiveTo investigate pediatric intensive care unit (PICU) admission in children with malignant and nonmalignant diseases who developed life-threatening complications.Patients And MethodsBetween 1999 and 2010, of the 1278 eligible pediatric patients treated for a malignant or nonmalignant disease, 54 were admitted to the PICU for respiratory distress (40.7%), neurological events (33.3%), severe sepsis (14.8%), and organ failure (11.2%).ResultsRate of PICU admission was 4.2%, with a 2-year cumulative incidence of 4.5%. Risk factors associated with higher cumulative incidence of PICU admission were older age at study entry (P=0.003), nonmalignant underlying disease (P=0.015), and hematopoietic stem cell transplantation (P<0.001). Patients with leukemia/lymphoma were more likely to be admitted to the PICU compared with patients with solid tumors (P<0.001). Patients admitted because of organ failure had the highest frequency of death within 90 days. Factors significantly associated with survival at 90 days from PICU admission included: no mechanical ventilation (P<0.001), nonmalignant underlying disease (P=0.030), and year of PICU admission after 2005 (P=0.038).ConclusionsNonmalignant disease and use of alternative hematopoietic stem cell transplantation were associated with higher risk of PICU admission. Close cooperation between hematologists and intensivists and definition of criteria for PICU admission and discharge contributed to increase in survival of these patients.

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