[Purpuras fulminans: development over a 15-year period]

Area of Science:

• Pediatric critical care medicine
• Infectious diseases

Context:

• This study retrospectively analyzed 81 pediatric intensive care unit (ICU) admissions between 1969 and 1983.
• Overall mortality in the ICU was 35% during the study period.
• Outcomes improved over time, with 12 deaths in 30 patients (1969-1974) versus 15 deaths in 51 patients (1975-1983).

Purpose:

• To evaluate trends in pediatric ICU mortality over a 15-year period.
• To identify factors associated with improved outcomes in critically ill children.
• To assess the impact of specific interventions and disease severity on mortality.

Summary:

• Improved outcomes were observed primarily in the smallest and least severe pediatric patients.
• Advancements in hemodynamic control, sedation, and artificial ventilation significantly contributed to better results.
• Mortality in severe cases did not improve, and all four children with purpura fulminans secondary to Hemophilus Influenzae infection died.

Impact:

• Highlights the critical role of technological and supportive care advancements in pediatric critical care.
• Underscores the persistent challenges in managing severe pediatric critical illnesses and specific infections like purpura fulminans.
• Provides historical data on pediatric ICU outcomes and treatment evolution over nearly two decades.