The Importance of Laminar Air Flow Reverse Isolation for Febrile Neutropenic Patients

Kim, Hae Sook; Lee, Ji Hye; Lee, Kun Soo

Abstract

PURPOSE: The aim of this study is to find out the role of laminar air flow with HEPA filter room reverse isolation in the treatment of chemotherapy-induced febrile neutropenic children with cancer.
METHODS
One hundred and nine episodes of febrile neutropenia from thirty eight patients were observed from January 2003 to January 2006. They were allocated to three groups of standard ward care, isolation after the onset of fever and isolation before the fever. Profiles of infection, clinical courses and survival rate were compared among these three groups.
RESULTS
Fifty two episodes were included to standard ward care, forty four episodes to isolation after the onset of fever and thirteen episodes to isolation before the fever. In the group of isolation before the fever, the durations of fever and antibiotics treatment were significantly shorter and the level of C-reactive protein was lower than other two groups. No statistically significant differences were observed in the overall incidence of defined infections, frequency of disseminated intravascular coagulation (DIC) and survival rate among these groups. In patients with DIC, one in eight episodes in isolation groups (13%) and four in nine episodes in standard ward care group (44%) were dead.
CONCLUSION
Isolation before the onset of fever in neutropenic cancer children affected the durations of fever and antibiotics treatment. Although it was not statistically significant, we assume that isolation might influence to the survival rate.