ECLS in pertussis: does it have a role?

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The Utilization of Oropharyngeal Intratracheal PAMP Administration and Bronchoalveolar Lavage to Evaluate the Host Immune Response in Mice
12:27

The Utilization of Oropharyngeal Intratracheal PAMP Administration and Bronchoalveolar Lavage to Evaluate the Host Immune Response in Mice

Published on: April 2, 2014

G D Williams1, A Numa, J Sokol

  • 1Children's Intensive Care Unit, Sydney Children's Hospital, Randwick, NSW, Australia. G.Williams@unsw.edu.au

Intensive Care Medicine
|December 5, 1998
PubMed

Insights

Extracorporeal circulatory life support (ECLS) offers limited benefit for infants with severe Bordetella pertussis infection, especially those with cardiac dysfunction. Most infants with cardiac involvement and respiratory failure do not survive despite ECLS.

Area of Science:

  • Pediatric critical care medicine
  • Infectious diseases
  • Cardiopulmonary support

Background:

  • Severe Bordetella pertussis infection can lead to respiratory failure in infants.
  • Extracorporeal circulatory life support (ECLS) is a potential treatment for severe respiratory failure.
  • The efficacy of ECLS in pediatric pertussis is not well-established.

Observation:

  • A single case report of an infant with severe pertussis treated with ECLS showed a fatal outcome due to cardiac and cerebral insults.
  • A review of the Extracorporeal Life Support Organization (ELSO) database revealed a high mortality rate (17/22) in infants with pertussis receiving ECLS.
  • Nonsurvivors often presented with circulatory collapse and severe respiratory failure, succumbing to hypoxic-ischemic cerebral injury.

Findings:

  • Infants with Bordetella pertussis infection and cardiac dysfunction have a poor prognosis, even with ECLS.
  • A subgroup of patients with isolated respiratory failure may potentially benefit from ECLS.
  • ECLS is unlikely to improve outcomes for patients with severe cardiac and cerebral insults.

Implications:

  • The use of ECLS in pediatric pertussis patients with cardiac dysfunction should be carefully considered.
  • Further research is needed to identify subgroups of pertussis patients who may benefit from ECLS.
  • Early recognition of cardiac involvement is crucial for determining prognosis in severe pertussis.
Abstract

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