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在儿科重症监护病房中严重的咳感染:一个多中心研究

Nihal Akçay¹, Demet Tosun², İlyas Bingöl²

¹Department of Pediatric Intensive Care Unit, Kanuni Sultan Süleyman Training and Research Hospital, University of Health Sciences, Istanbul, 34093, Turkey. drnihalakcay@gmail.com.

European journal of pediatrics

|January 15, 2025

概括

婴儿严重的百日咳可能导致严重的疾病和死亡. 对于患有严重症状的婴儿,如高白细胞计数和呼吸或心力衰竭,可能需要交换输血.

科学领域:

儿科儿科儿科
传染性疾病传染性疾病
关键护理医学关键护理医学

背景情况:

百日咳是由 Bordetella pertussis 引起的,是一种高度传染的呼吸道感染,主要影响婴儿.
尽管接种了疫苗,但百日咳仍然是婴儿发病和死亡的重要原因,特别是在那些太年轻而无法完全免疫的婴儿中.
交换输血是一种潜在的干预措施,用于严重的百日咳病例复杂的肺高血压或心脏性休克,特别是当伴随着白细胞症.

研究的目的:

评估儿科重症监护室 (PICU) 中关键性百日咳疾病的临床过程和结果.
为了比较接受交换输血与没有接受交换输血的严重百日咳的婴儿之间的临床特征和结果.

主要方法:

在2023年1月1日至2023年12月31日期间进行了一项多中心的回顾性研究.
分析了50名被确认患有波多菌百日咳感染 (通过PCR) 的婴儿,这些婴儿被录入PICU.
为了进行比较分析,患者被分为交换输血组和非交换输血组.

主要成果:

在研究队列中,严重百日咳的总死亡率为8%.
接受交换血液输血的婴儿表现出明显更高的白细胞计数 (WBC),淋巴细胞计数,中性粒细胞计数和C反应蛋白 (CRP) 水平.
肺高血压,呼吸衰竭,心力衰竭/心脏骤停,因诺托普需求和机械呼吸在交换输血组中更为频繁.

结论:

百日咳可以导致严重并发症和死亡危急病的婴儿,特别是年轻的,未免疫的婴儿.
婴儿有严重 pertussis 呈现高炎症标志物 (CRP,WBC) 和显著的心脏或呼吸系统损害的婴儿可以接受交换输血.

关键词:

孩子孩子孩子孩子关键的护理关键的护理交换输血输血交换输血交换输血严重的百日咳严重的百日咳

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