Association of thrombocytopenia on secondary infection and mortality in pediatric intensive care unit patients receiving continuous renal replacement therapy

Year 2025, Volume: 8 Issue: 2, 303 - 307, 21.03.2025

Gültaç Evren

https://doi.org/10.32322/jhsm.1633719

Abstract

Aims: Continuous renal replacement therapy (CRRT) is a widely used treatment modality in pediatric patients. We aimed to evaluate the susceptibility of thrombocytopenia to secondary infection and mortality during intensive care unit admission and the initiation of CRRT in patients admitted to the pediatric intensive care unit.
Methods: We conducted a retrospective study of patients in a tertiary pediatric intensive care unit who underwent CRRT between February 2021 and July 2024. The study included 34 patients who underwent CRRT.
Results: The study population consisted of patients with a median age of 26 months and 58.8% were male. At pediatric intensive care units (PICU) admission, 10 (29.4%) patients had thrombocytopenia, whereas 15 (44.1%) had thrombocytopenia at CRRT initiation. Patients with thrombocytopenia at the start of CRRT had a greater risk of mortality. Mortality approached significance in patients with thrombocytopenia at PICU admission. The risk of infection was significantly increased in patients with thrombocytopenia at the start of CRRT according to univariate and multivariate regression analyses (p=0.01).
Conclusion: The detection of thrombocytopenia at the beginning of CRRT is associated with a higher secondary infection rate and mortality during pediatric intensive care hospitalization. CRRT and thrombocytopenia negatively impact immune function, and further prospective studies are needed to assess their association with subsequent infection risk.

Keywords

Continuous renal replacement therapy, pediatric intensive care, secondary infection, thrombocytopenia, mortality

Ethical Statement

Izmir Bakircay Univercity

Supporting Institution

None

Project Number

1668

Sürekli renal replasman tedavisi uygulanan çocuk yoğun bakım ünitesi hastalarında trombositopeninin sekonder enfeksiyon ve mortalite ile ilişkisi

Abstract

Amaç
Sürekli renal replasman tedavisi (SRRT), pediatrik hastalarda yaygın olarak kullanılan bir tedavi yöntemidir. Yoğun bakım ünitesine kabul sırasında ve pediatrik yoğun bakım ünitesine kabul edilen hastalarda CRRT'nin başlatılması sırasında trombositopeninin sekonder enfeksiyona ve mortaliteye duyarlılığını değerlendirmeyi amaçladık.
Yöntem
Şubat 2021 ile Temmuz 2024 arasında SRRT uygulanan üçüncü basamak Pediatrik Yoğun Bakım Ünitesindeki hastalarla ilgili retrospektif bir çalışma yürüttük. Çalışmaya SRRT uygulanan 34 hasta dahil edildi.
Bulgular
Çalışma popülasyonu, medyan yaşı 26 ay olan hastalardan oluşuyordu ve %58,8'i erkekti. PICU'ya kabulde 10 (%29,4) hastada trombositopeni vardı, buna karşın 15 (%44,1) hastada CRRT başlangıcında trombositopeni vardı. CRRT başlangıcında trombositopenisi olan hastalarda mortalite riski daha yüksekti. PICU'ya kabul edilen trombositopenili hastalarda mortalite önemli düzeye yaklaştı. Tek değişkenli ve çok değişkenli regresyon analizlerine göre SRRT başlangıcında trombositopenili hastalarda enfeksiyon riski önemli ölçüde artmıştı (p = 0,01).
Sonuç
SRRT başlangıcında trombositopeninin saptanması, pediatrik yoğun bakım hastanesinde yatış sırasında daha yüksek sekonder enfeksiyon oranı ve mortalite ile ilişkilidir. SRRT ve trombositopeni bağışıklık fonksiyonunu olumsuz etkiler ve bunların sonraki enfeksiyon riski ile ilişkisini değerlendirmek için daha fazla prospektif çalışmaya ihtiyaç vardır.

Keywords

Sürekli renal replasman tedavisi, pediatrik yoğun bakım, trombositopeni, sekonder enfeksiyon, mortalite

Ethical Statement

İzmir Bakırçay Üniversitesi

Supporting Institution

Yok

Project Number

1668

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