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Infant pertussis deaths and the management of cardiovascular compromise

J A McEniery1, R G Delbridge, D M Reith

  • 1Intensive Care, Royal Children's Hospital, Brisbane, Queensland, Australia. Julie_McEniery@health.qld.gov.au

Journal of Paediatrics and Child Health
|March 11, 2004
PubMed

Insights

Severe pertussis infection in infants can cause fatal cardiovascular compromise. Combination therapy with nitric oxide and sildenafil shows promise for treating these severe hemodynamic effects, warranting clinical trials.

Area of Science:

  • Pediatrics
  • Cardiology
  • Infectious Diseases

Background:

  • Infants infected with Bordetella pertussis face a high risk of death due to overwhelming cardiovascular compromise.
  • The precise mechanisms underlying this severe disease remain incompletely understood.

Observation:

  • Three case histories of infants with severe pertussis were analyzed, including one survivor.
  • Two infants died despite intensive care, including pressor therapy and milrinone.
  • One infant survived after receiving nitric oxide and sildenafil treatment.

Findings:

  • Sildenafil in combination with nitric oxide demonstrated therapeutic potential for managing the hemodynamic consequences of pertussis toxaemia.
  • This combination therapy offers a promising approach for severe cardiovascular compromise in infants with pertussis.

Implications:

  • The findings suggest that nitric oxide and sildenafil combination therapy warrants further investigation in clinical trials.
  • Establishing the efficacy of this treatment could lead to improved outcomes for infants with severe pertussis.
  • This research highlights potential novel therapeutic strategies for managing life-threatening hemodynamic instability in neonatal infections.

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