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Artificial ventilation in severe pertussis.

J Gillis1, T Grattan-Smith, H Kilham

  • 1Intensive Care Unit, Children's Hospital, Camperdown, Sydney, Australia.

Archives of Disease in Childhood
|April 1, 1988
PubMed
Summary
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Early intubation and ventilation in severe pertussis (whooping cough) can be safely used in infants. This intervention may prevent hypoxic damage and death, especially in those under 3 months old.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Pertussis (whooping cough) remains a significant cause of respiratory illness in infants.
  • Severe pertussis can lead to respiratory failure requiring intensive care.

Purpose of the Study:

  • To evaluate the outcomes of intubation and mechanical ventilation in infants with culture-proven pertussis admitted to the intensive care unit.
  • To determine the safety and efficacy of early ventilatory support in severe pertussis.

Main Methods:

  • Retrospective review of pediatric intensive care unit admissions over eight years.
  • Analysis of patients diagnosed with culture-proven pertussis.
  • Evaluation of ventilatory support, intubation indications, and patient outcomes.

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Main Results:

  • Twenty-four of 789 children with pertussis required intensive care; 13 needed ventilatory support.
  • Ventilation was initiated primarily for significant apnea, mainly in infants under 3 months old within 16 days of cough onset.
  • Ventilation was generally not difficult or prolonged, and coughing spasms were not problematic. Severe bacterial pneumonia indicated a poor prognosis.

Conclusions:

  • Intubation and ventilation can be safely employed in very severe pertussis infections.
  • Early ventilatory support should not be a last resort for critically ill infants due to the high risk of hypoxic damage and mortality.