The availability of HEPA‐filtered rooms and the incidence of pneumonia in patients after haematopoietic stem cell transplantation (HSCT): results from a prospective, multicentre, eastern European study. Issue 11 (20th December 2013)

• Record Type: Journal Article
• Authors: Vokurka, Samuel; Bystrická, Eva; Svoboda, Tomáš; Škoda Gorican, Irena Katja; Sever, Matjaz; Mazur, Ewa; Kopinska, Anna; Pavlicová, Vladislava; Mocanu, Otilia; Tanase, Alina; Ghelase, Rodica; Zítková, Marie; Labudíková, Monika; Raida, Ludek; Hrabánková‐Navrátilová, Darja; Bocková, Jana
• Is Part Of: Journal of clinical nursing. Volume 23:Issue 11/12(2014)
• Page Start: 1648
• Page End: 1652
• Publication Date: 2013-12-20
• Subjects: Nursing -- Periodicals; Clinical medicine -- Periodicals; 610.7305
• DOI: 10.1111/jocn.12286
• Languages: English
• ISSNs: 0962-1067

Abstract

<abstract abstract-type="main" id="jocn12286-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jocn12286-sec-0001" sec-type="section"> <title>Aims and objectives</title> <p>To establish the availability of High Efficiency Particulate Air (HEPA)‐ and nonHEPA‐filtered rooms in eastern European transplant centres and to investigate the impact on incidence of pneumonia and mortality after haematopoietic stem cell transplantation <bold>(</bold>HSCT).</p> </sec> <sec id="jocn12286-sec-0002" sec-type="section"> <title>Background</title> <p>Barrier nursing in HEPA‐filtered rooms is generally recommended for patients undergoing HSCT. There are only limited data on the availability of HEPA‐filtered rooms and the impact on incidence of pneumonia and mortality.</p> </sec> <sec id="jocn12286-sec-0003" sec-type="section"> <title>Design</title> <p>A prospective, observational, international study.</p> </sec> <sec id="jocn12286-sec-0004" sec-type="section"> <title>Methods</title> <p>Monitoring cards were distributed within the East Forum EBMT‐Nurses Group cooperating centres, and 689 consecutive patients were registered in 1/2010‐6/2012. Patients were monitored for 100 days post‐transplant.</p> </sec> <sec id="jocn12286-sec-0005" sec-type="section"> <title>Results</title> <p>In patients undergoing autologous HSCT, pneumonia developed in 14/400 (3·5%) and was the cause of death in 2/14 (14%) of patients. There was no significant difference in mortality between HEPA‐filtered and nonHEPA‐filtered groups (4·5% vs. 4·9%, respectively). 239/400 (59%) transplantations were performed in single‐bed rooms [190/239 (79%) HEPA‐filtered] and 161 (41%) in two‐bed rooms [28/161 (17%) HEPA‐filtered]. In allogeneic transplantation, pneumonia developed in 24/289 (8·3%) and was the cause of death in 11/24 (45%) of patients. There was no significant difference in mortality between HEPA‐filtered and non‐HEPA‐filtered groups (14% vs. 17%, respectively). 281/289 (97%) of allogeneic transplantations were performed in single‐bed rooms [254/281 (90%) HEPA‐filtered], and pneumonia was more frequent in patients on corticosteroids and in rooms without HEPA.</p> </sec> <sec id="jocn12286-sec-0006" sec-type="section"> <title>Conclusion</title> <p>The incidence of pneumonia in the autologous transplantation setting is low. More pneumonia was observed in the allogeneic HSCT group, especially in patients on corticosteroids. There was a trend towards a lower incidence of pneumonia in allogeneic HSCT patients treated in HEPA‐filtered rooms.</p> </sec> <sec id="jocn12286-sec-0007" sec-type="section"> <title>Relevance to clinical practice</title> <p>Autologous HSCT transplantation may safely be performed without HEPA filtration. HEPA filtration might be preferable in patients undergoing allogeneic transplantation.</p> </sec> </abstract>