3.3 | Patterns of ICU transfer
A total of 44 patients were transferred to the ICU within 100 days after
transplant. Of these 44 patients, 34 exhibited elevated pediatric early
warning signs (PEWS). These signs refer to clinical changes in a
patient’s respiratory, cardiovascular, and/or neurological state
indicative of the potential for rapid deterioration.25In this study, the following symptoms were classified as elevating a
patient’s PEWS score: tachypnea, tachycardia, blood pressure instability
(hypotension or hypertension), increased work of breathing,
desaturations, hypoxia, apnea, and altered mental status. Of these 34
patients, 19 patients exhibited an elevated PEWS score for respiratory
symptoms (tachypnea, increased work of breathing, desaturations, and
apnea) alone. The most common causes of ICU transfer were tachypnea,
tachycardia, blood pressure instability, fluid overload, and altered
mental status. Indications for ICU transfer with a statistically
significant increase between RVI+ and RVI- groups included fluid
overload (p=0.025) and blood pressure instability (p=0.034). (Table 3)
Overall, increased requirement for ICU transfer was found to be
statistically associated with positive pre-transplant RVI PCR results.
While in the first 25 days post-transplant ICU transfer remained
comparable between the RVI- and RVI+ groups, afterward the disparity
between the two greatly increased up to 100 days after HSCT. (Fig. 2)