Transfusion of leukocyte-depleted red blood cells is not a risk factor for nosocomial infections in critically ill children

Judith van der Wal*, Marc van Heerde, Dick G. Markhorst, Martin C. J. Kneyber

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)

Abstract

Objectives: Transfusion of red blood cells is increasingly linked with adverse outcomes in critically ill children. We tested the hypothesis that leukocyte-depleted red blood cell transfusions were independently associated with increased development of bloodstream infections, ventilator-associated pneumonias, or urinary tract infections.

Design: Historical, descriptive cohort study.

Setting: Single-center, mixed medical-surgical, closed nine-bed pediatric intensive care unit of a tertiary university hospital.

Patients: All children

Interventions: None.

Results: One thousand one hundred twenty-three patients were admitted, of whom 503 (44.8%) were admitted for >48 hrs. Sixty-five (12.9%) had a nosocomial infection (incidence 19.3 per 1,000 pediatric intensive care unit admissions per year). Patients with a nosocomial infection were significantly more often male (72.3% vs. 27.7%, p = .033), had a higher Pediatric Risk of Mortality II score (median 19.1 [range, 6-44] vs. 18.0 [range, 2-39], p = .023), were more often ventilated (95.4% vs. 80.1%, p = .003), and received more often red blood cell transfusions (55.4% vs. 40.2%, p = .021). Multivariate logistic regression analysis showed that male gender (odds ratio, 2.07; 95% confidence interval, 1.14-3.76), presence of an indwelling central venous catheter (odds ratio, 2.41; 95% confidence interval, 1.29-4.48), and simultaneous use of more than one type of antimicrobial drug were independently associated with the development of nosocomial infections. Red blood cell transfusion was discarded as a predictor.

Conclusions: Transfusion of leukocyte-depleted red blood cells was not independently associated with the development of nosocomial infections in a heterogeneous group of critically ill children. (Pediatr Crit Care Med 2011; 12:519-524)

Original languageEnglish
Pages (from-to)519-524
Number of pages6
JournalPediatric critical care medicine
Volume12
Issue number5
DOIs
Publication statusPublished - Sep-2011

Keywords

  • critically ill children
  • nosocomial infection
  • outcome assessment (healthcare)
  • RBC transfusions
  • INTENSIVE-CARE-UNIT
  • VENTILATOR-ASSOCIATED PNEUMONIA
  • PROSPECTIVE COHORT
  • STREAM INFECTION
  • STRATEGIES
  • MORTALITY
  • OUTCOMES
  • STORAGE
  • LENGTH

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