Transforming pediatric intensive care unit outcomes in pediatric hematology-oncology and hematopoietic stem…

Cohort studyCritical care science· 2026

Transforming pediatric intensive care unit outcomes in pediatric hematology-oncology and hematopoietic stem cell transplantation through golden hour care in a low- and middle-income country: a 10-year analysis.

Indira Jayakumar, Milind Ballal, Nalla Anuraag Reddy … Jennifer McArthur

Pediatric Critical & Emergency CareCohort studyQ2IF 1.7

Care improvement bundle linked to fewer pediatric ICU deaths in oncology/transplant patients

Transforming pediatric intensive care unit outcomes in pediatric hematology-oncology and hematopoietic stem cell transplantation through golden hour care in a low- and middle-income country: a 10-year analysis.

Indira Jayakumar … Jennifer McArthur

Critical care science · 2026

Purpose

To evaluate the impact of a care improvement bundle focused on early intervention, communication, and multidisciplinary collaboration by comparing outcomes across two 5-year periods before and after its implementation.

Methods

A single-center, retrospective study was conducted in the Onco-Critical Care pediatric intensive care unit of a tertiary cancer referral hospital in South India, comparing outcomes from two eras: the pre-bundle cohort (2014 - 2018) and the post-bundle cohort (2019 - 2023).

Results

ICU deaths nearly halved after the bundle began

Pre-bundle (2014-2018)

21.8%

Post-bundle (2019-2023

11.4%

More results

From 2014 - 2018, 516 hematopoietic stem cell transplantations and 336 new oncology cases were managed; from 2019 - 2023, these increased to 579 hematopoietic stem cell transplantations and 784 new oncology patients.

More results

The use of costly interventions decreased, with invasive ventilation dropping from 30.9% to 18.0% (p < 0.0001) and renal replacement therapy from 14.8% to 4.3% (p = 0.0001), indicating both improved outcomes and reduced resource utilization.

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Conclusion · 1 of 2

The implementation of a care improvement bundle to foster interdisciplinary collaborative communication and earlier recognition of critical illness enabled golden hour care on the floors, resulting in significant improvements in outcomes for pediatric oncology and hematopoietic stem cell transplantation patients.

Conclusion · 2 of 2

This care improvement bundle is feasible, easily scalable, and can be systemically incorporated across the centers.

Transforming pediatric intensive care unit outcomes in pediatric hematology-oncology and hematopoietic stem cell transplantation through golden hour care in a low- and middle-income country: a 10-year analysis.

Transforming pediatric intensive care unit outcomes in pediatric hematology-oncology and hematopoietic stem cell transplantation through golden hour care in a low- and middle-income country: a 10-year analysis.

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