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Extracorporeal life support in pertussis.
Suneel Pooboni1, Neil Roberts, Claire Westrope
1Department of Extracorporeal Membrane Oxygenation and Paediatric Intensive Care, Glenfield Hospital, Groby Road, Leicester LE3 9PQ, UK.
Pediatric Pulmonology
|September 2, 2003
Summary
Severe pertussis (whooping cough) in infants can be fatal. Extracorporeal membrane oxygenation (ECMO) offers a potential treatment for respiratory failure, but mortality remains high, especially with multi-organ dysfunction.
Area of Science:
- Pediatrics
- Infectious Diseases
- Critical Care Medicine
Background:
- Severe B. pertussis (pertussis) infection presents with respiratory failure, pulmonary hypertension, and leukocytosis in infants.
- Unvaccinated infants under 3 months are particularly vulnerable to severe pertussis complications.
Purpose of the Study:
- To analyze the course and outcomes of severe B. pertussis infection treated with extracorporeal membrane oxygenation (ECMO).
- To evaluate the efficacy and identify factors associated with mortality in infants receiving ECMO for pertussis.
Main Methods:
- Retrospective case analysis of infants treated with ECMO for severe B. pertussis infection over a decade.
- Review of clinical data including age, vaccination status, neutrophil count, and organ dysfunction.
Main Results:
- Out of 12 infants receiving ECMO for pertussis, 7 (58%) died.
- High mortality was linked to elevated neutrophil counts and multi-organ dysfunction (pulmonary hypertension, hypotension, renal insufficiency, seizures).
- All treated infants were unvaccinated and under 3 months old.
Conclusions:
- ECMO is a viable option for infants with pertussis-related respiratory failure unresponsive to mechanical ventilation.
- Further research is needed to optimize ECMO management for infants with severe pertussis and multi-organ dysfunction.