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Botulism in the Pediatric Intensive Care Units in the United States: Interrogating a National Database
Cynthia Howes1, Kerith Hiatt1, Katherine Turlington2
1Department of Pediatrics, Division of Pediatric Critical Care, University of Maryland Medical Center, Baltimore, Maryland, United States.
Insights
Pediatric botulism cases requiring intensive care show improved outcomes, with shorter hospital stays and less need for mechanical ventilation. Advances in pediatric intensive care unit (PICU) may be contributing to these better results for children with botulism.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Neurology
Background:
- Botulism in children can lead to severe complications requiring intensive care.
- Limited data exists on pediatric botulism cases admitted to the pediatric intensive care unit (PICU).
Purpose of the Study:
- To describe the outcomes of pediatric botulism patients admitted to the PICU.
- To analyze trends in pediatric botulism care and outcomes over time.
Main Methods:
- Retrospective cohort study utilizing Virtual Pediatric Systems (VPS) data.
- Analysis of PICU admissions for botulism in children from 2009 to 2016.
- Comparison of patient characteristics and outcomes with existing literature.
Main Results:
- A total of 380 pediatric botulism cases were identified over an 8-year period.
- The study cohort exhibited a shorter median length of stay (4.6 days) compared to similar studies.
- A lower percentage of patients (40%) required mechanical ventilation, with decreased duration of ventilation and PICU stay observed.
Conclusions:
- Outcomes for pediatric botulism patients in the PICU have improved, with reduced length of stay and mechanical ventilation needs.
- Advances in pediatric intensive care unit (PICU) management likely contribute to these positive trends.
- Further research is warranted to fully understand the factors driving these improvements in pediatric botulism care.
Abstract:
Botulism in children can have severe complications necessitating intensive care. The current literature lacks data of children with botulism requiring critical care. We aim to describe the outcomes of pediatric botulism in the pediatric intensive care unit (PICU). Retrospective cohort data from Virtual Pediatric Systems (VPS, LLC, Los Angeles, California), from 2009 to 2016 including all PICU admissions among children with botulism, were analyzed. Characteristics and outcomes were compared with similar studies. A total of 380 children were identified over 8 years. Our cohort had the shortest length of stay (median 4.6 days), the smallest percent requiring mechanical ventilation (40%), and the highest median age (120 days) amongst comparable studies. Length of mechanical ventilation and PICU stay has decreased among children with botulism. Advances in PICU care may have contributed to these improved outcomes.
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