Zinter Matt S, Dvorak Christopher C, Auletta Jeffery J
Division of Critical Care Medicine, UCSF Benioff Children's Hospital, University of California, San Francisco, San Francisco, CA, United States.
Division of Allergy, Immunology, and Blood and Marrow Transplantation, UCSF Benioff Children's Hospital, University of California, San Francisco, San Francisco, CA, United States.
Front Oncol. 2020 Sep 16;10:581447. doi: 10.3389/fonc.2020.581447. eCollection 2020.
Pediatric allogeneic hematopoietic cell transplant (HCT) survival is limited by the development of post-transplant infections. In this overview, we discuss a clinical approach to the prompt recognition and treatment of fever and hypotension in pediatric HCT patients. Special attention is paid to individualized hemodynamic resuscitation, thorough diagnostic testing, novel anti-pathogen therapies, and the multimodal support required for recovery. We present three case vignettes that illustrate the complexities of post-HCT sepsis and highlight best practices that contribute to optimal transplant survival in children.
小儿异基因造血细胞移植（HCT）的存活率受到移植后感染的限制。在本综述中，我们讨论了一种针对小儿HCT患者发热和低血压的快速识别与治疗的临床方法。特别关注个性化的血流动力学复苏、全面的诊断检测、新型抗病原体疗法以及恢复所需的多模式支持。我们展示了三个病例 vignettes，阐述了HCT后败血症的复杂性，并强调了有助于儿童移植存活率达到最佳的最佳实践。
