{
  "abstract": "Background Haematopoietic reconstitution is marked by immunosuppression and pancytopenia, representing the initial high-risk period following allogeneic haematopoietic stem cell transplantation (allo-HSCT). However, little is known about the occurrence of acute respiratory distress syndrome (ARDS) during haematopoietic reconstitution.Methods This retrospective cohort study included 1024 patients who underwent allo-HSCT in Suzhou from 2016 to 2019. Clinical data and follow-up information were collected from medical records. ARDS was defined according to the new global definition established in 2023. The primary outcomes were the incidence of ARDS during haematopoietic reconstitution after allo-HSCT and 1 year post-transplantation mortality.Results Among the 1024 patients, 58 (5.6%) died within 1 year after HSCT. ARDS during haematopoietic reconstitution occurred in 45 patients (4.4%), of whom 29 were treated with high-flow nasal oxygen only. The median onset of ARDS was 9.0 days post-transplantation. Patients who developed ARDS had a significantly higher risk of 1-year mortality after HSCT (HR 7.99, 95% CI 4.13 to 15.44). Independent risk factors for ARDS during haematopoietic reconstitution included longer intervals between disease onset and transplantation (OR 1.01, 95% CI 1.00 to 1.02), a greater number of previous HSCTs (OR 1.82, 95% CI 1.04 to 3.19), and higher red cell distribution width at admission (OR 1.12, 95% CI 1.02 to 1.22).Conclusions According to the new 2023 global definition, ARDS during haematopoietic reconstitution is independently associated with increased 1-year mortality after allo-HSCT. Early identification of ARDS during this period is particularly important, and recognising its risk factors may aid in timely diagnosis and intervention.",
  "authors": [
    {
      "affiliations": [
        "Department of Emergency and Critical Care Medicine, The Fourth Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China",
        "Institute of Critical Care Medicine, Soochow University Medical College, Suzhou, Jiangsu, China"
      ],
      "name": "Chang Gao"
    },
    {
      "affiliations": [
        "National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China",
        "Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, First Affiliated Hospital of Soochow University Key Laboratory of Thrombosis and Hemostasis Ministry of Health, Suzhou, Jiangsu, China"
      ],
      "name": "Ying Wang"
    },
    {
      "affiliations": [
        "Department of Emergency and Critical Care Medicine, The Fourth Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China",
        "Institute of Critical Care Medicine, Soochow University Medical College, Suzhou, Jiangsu, China"
      ],
      "name": "Di Yin"
    },
    {
      "affiliations": [
        "Institute of Critical Care Medicine, Soochow University Medical College, Suzhou, Jiangsu, China",
        "Department of Pulmonary and Critical Care Medicine, The Fourth Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China"
      ],
      "name": "Daxiong Zeng"
    },
    {
      "affiliations": [
        "Department of Critical Care Medicine, Taicang Hospital Affiliated to Soochow University, Taicang, Jiangsu, China"
      ],
      "name": "Ye Gao"
    },
    {
      "affiliations": [
        "Department of Emergency and Critical Care Medicine, The Fourth Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China"
      ],
      "name": "Yu He"
    },
    {
      "affiliations": [
        "Department of Emergency and Critical Care Medicine, The Fourth Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China"
      ],
      "name": "Yuanyuan Yang"
    },
    {
      "affiliations": [
        "Institute of Critical Care Medicine, Soochow University Medical College, Suzhou, Jiangsu, China"
      ],
      "name": "Haiyan Wang"
    },
    {
      "affiliations": [
        "National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China",
        "Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, First Affiliated Hospital of Soochow University Key Laboratory of Thrombosis and Hemostasis Ministry of Health, Suzhou, Jiangsu, China"
      ],
      "name": "Depei Wu"
    },
    {
      "affiliations": [
        "Department of Emergency and Critical Care Medicine, The Fourth Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China",
        "Institute of Critical Care Medicine, Soochow University Medical College, Suzhou, Jiangsu, China"
      ],
      "name": "Qiang Guo"
    }
  ],
  "title": "ARDS during haematopoietic reconstruction after allogeneic haematopoietic stem cell transplantation (allo-HSCT) in non-child patients: based on the new global definition",
  "uid": "e8f4b320-3542-5e37-a8e6-33670f37fb2d"
}