{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:27:34Z","timestamp":1789187254619,"version":"build-2803163510"},"reference-count":27,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T00:00:00Z","timestamp":1653955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Noninvasive ventilation (NIV) has become more studied in immunocompromised patients. However, it has not been studied in hematopoietic cell transplantation (HCT) recipients, who have higher mortality and higher pulmonary complication rates than other immunocompromised patients. This population may be prone to negative effects from this treatment modality. The aim of this study was to determine whether NIV use is associated with worse outcomes in this vulnerable patient population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>A secondary analysis of a retrospective multi-center database was performed. Twelve pediatric ICUs across the United States enrolled HCT subjects from 2009\u20132014 that were admitted to the pediatric ICU (PICU) with the diagnosis of acute respiratory failure. Subjects exposed to NIV prior to intubation were compared against those not exposed to NIV. Our primary outcome was all-cause mortality at 90 d; secondary outcomes included ventilator-free days (VFD) at 28 d and development of pediatric ARDS. Multivariable logistic and linear regression models were constructed using variables significant on univariable analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Two-hundred eleven subjects were included. Of these, 82 (39%) received NIV prior to intubation. Those that received NIV prior to intubation were older (13 vs 6 y,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) and more commonly diagnosed with respiratory distress (90% vs 74%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .004). On multivariable analysis, NIV use prior to intubation was associated with a higher PICU mortality (hazard ratio 1.51 [95% CI 1.18\u20132.28],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .02) and fewer VFD at 28 d (\u03b2 \u22123.50 [95% CI \u22126.09 to 0.91],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .008). Those with NIV exposure prior to intubation also had higher rates of development of pediatric ARDS (95% vs 78%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In this cohort of children post-HCT, NIV use prior to intubation was associated with worse outcomes. The benefits and risks of NIV in this patient population should be carefully evaluated prior to its use, and careful patient selection is crucial for its optimal utilization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.09776","type":"journal-article","created":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T09:40:21Z","timestamp":1653990021000},"page":"1121-1128","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Noninvasive Ventilation Exposure Prior to Intubation in Pediatric Hematopoietic Cell Transplant Recipients"],"prefix":"10.1177","volume":"67","author":[{"given":"Daniel T","family":"Cater","sequence":"first","affiliation":[{"name":"Division of Critical Care, Department of Pediatrics, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie C","family":"Fitzgerald","sequence":"additional","affiliation":[{"name":"Division of Critical Care, Department of Anesthesiology and Critical Care, Children\u2019s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shira J","family":"Gertz","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, New Jersey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer A","family":"McArthur","sequence":"additional","affiliation":[{"name":"Division of Critical Care, Department of Pediatrics, St Jude Children\u2019s Research Hospital, Memphis, Tennessee."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan C","family":"Daniel","sequence":"additional","affiliation":[{"name":"Division of Critical Care, Department of Pediatrics, Nationwide Children\u2019s Hospital, The Ohio State University, Columbus, Ohio."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kris M","family":"Mahadeo","sequence":"additional","affiliation":[{"name":"Stem Cell Transplantation and Cellular Therapy, Children\u2019s Cancer Hospital, University of Texas M.D. Anderson Cancer Center, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deyin D","family":"Hsing","sequence":"additional","affiliation":[{"name":"Division of Critical Care, Department of Pediatrics, Weil Cornell Medical College, New York-Presbyterian Hospital, New York City, New York."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lincoln S","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Department of Pediatrics, Seattle Children\u2019s Hospital, University of Washington, Seattle, Washington."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Pike","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney M","family":"Rowan","sequence":"additional","affiliation":[{"name":"Division of Critical Care, Department of Pediatrics, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Hematopoietic Cell Transplant subgroup of the Pediatric Acute Lung Injury and Sepsis Investigator Network","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,5,31]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2004.09.008"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.24953\/turkjped.2019.01.010"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2019.06.004"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2009.03.019"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0119-2019"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000000673"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.07170"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e3181d904c0"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.PCC.0000225089.21176.0B"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-019-2575-6"},{"key":"e_1_3_2_12_2","first-page":"8106145","article-title":"Outcomes of noninvasive positive-pressure ventilation in acute respiratory distress syndrome and their predictors: a national cohort","volume":"2019","author":"Taha A","year":"2019","unstructured":"Taha A, , Larumbe-Zabala E, , Abugroun A, , Mohammedzein A, , Naguib MT, , Patel M. Outcomes of noninvasive positive-pressure ventilation in acute respiratory distress syndrome and their predictors: a national cohort. 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Risk factors for noninvasive ventilation failure in children post-hematopoietic cell transplant. 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