Critical Pertussis Illness in Children

• DOI: 10.1097/pcc.0b013e31828a70fe
• Publication Date: 2013-04-02T15:39:24Z
• Authors: John T. Berger; Joseph A. Carcillo; Thomas P. Shanley; David L. Wessel; Amy Clark; Richard Holubkov; Kathleen L. Meert; Christopher J. L....; Robert A. Berg; Sabrina Heidemann; Rick Harrison; Murray Pollack; Heidi Dalton; Eric Harvill; Alexia Karanikas; Teresa Liu; Jeri S. Burr; Allan Doctor; J. Michael Dean; Tammara L. Jenkins; Carol E. Nicholson
• Keywords: Leukoreduction

Pertussis persists in the United States despite high immunization rates. This report characterizes presentation and acute course of critical pertussis by quantifying demographic data, laboratory findings, clinical complications, care therapies among children requiring admission to PICU.Prospective cohort study.Eight PICUs comprising Eunice Kennedy Shriver National Institute for Child Health Human Development Collaborative Pediatric Critical Care Research Network 17 additional across States.Eligible patients had confirmation infection, were younger than 18 years old, died PICU or admitted at least 24 hours between June 2008 August 2011.None.A total 127 identified. Median age was 49 days, 105 (83%) less 3 months old. Fifty-five (43%) required mechanical ventilation 12 (9.4%) during initial hospitalization. Pulmonary hypertension found 16 (12.5%) present 75% who died, compared with 6% survivors (p < 0.001). WBC significantly higher those 0.001), pulmonary nonsurvivors Age, sex, status did not differ nonsurvivors. Fourteen received leukoreduction therapy (exchange transfusion [12], leukopheresis [1], both [1]). Survival benefit apparent.Pulmonary may be associated mortality illness. Elevated is need ventilation, hypertension, risk. indicated elucidate how immune responsiveness, elevated contribute morbidity whether might efficacious.