Kazantzi Maria S, Prezerakou Anargyroula, Kalamitsou Serafeia N, Ilia Stavroula, Kalabalikis Panagiotis K, Papadatos John, Sdougka Maria M, Briassoulis George, Tsolia Maria N
2nd Department of Pediatrics, University of Athens, P & A Kuriakou Children's Hospital, Athens, Greece.
Pediatric Intensive Care Unit, Aghia Sofia Children's Hospital, Athens, Greece.
J Paediatr Child Health. 2017 Mar;53(3):257-262. doi: 10.1111/jpc.13427. Epub 2017 Jan 6.
To describe children with pertussis who required intensive care.
This is a retrospective analysis of pertussis admissions to all (six) national intensive care units in Greece from 2003 to 2013.
A total of 31 children were included, 28 of whom were younger than 12 months old. Cough was the most prominent symptom, being present in 27 of 31 (87%) patients, and on admission, only 7 (22.6%) satisfied the case definition. Mechanical ventilation was initiated in 13 (42%) patients. Six patients died because of respiratory failure (two) or multi-organ system failure (four). The patients who died had significantly higher white blood cell counts (WBC) (77 800-31 600, P = 0.031) and neutrophils (29 016-12 795, P = 0021) than those who survived and lower minimum values of serum sodium (125-133, P = 0002). They also had a longer duration of hospitalisation prior to their paediatric intensive care unit admission (6-1 days, P = 0022). Three patients were diagnosed with pulmonary hypertension, and only one of them survived. Age, gender and immunisation status did not differ between survivors and non-survivors. Two patients received exchange blood transfusion, and survival benefit was not apparent.
Young infants are at risk of severe pertussis, resulting in serious complications or death. Elevated WBC and low serum sodium are associated with higher mortality. Despite advances in life support and treatment of organ failure in childhood critical illness, pertussis still has substantial mortality.
描述需要重症监护的百日咳患儿。
这是一项对2003年至2013年希腊所有（六个）国家重症监护病房收治的百日咳患者的回顾性分析。
共纳入31名儿童，其中28名年龄小于12个月。咳嗽是最突出的症状，31名患者中有27名（87%）出现咳嗽，入院时只有7名（22.6%）符合病例定义。13名（42%）患者开始进行机械通气。6名患者因呼吸衰竭（2名）或多器官系统衰竭（4名）死亡。死亡患者的白细胞计数（WBC）（77800 - 31600，P = 0.031）和中性粒细胞（29016 - 12795，P = 0.021）显著高于存活患者，血清钠最低值更低（125 - 133，P = 0.002）。他们在入住儿科重症监护病房之前的住院时间也更长（6 - 1天，P = 0.022）。3名患者被诊断为肺动脉高压，其中只有1名存活。存活者和非存活者在年龄、性别和免疫状态方面没有差异。2名患者接受了换血治疗，但生存获益不明显。
小婴儿有患重症百日咳的风险，可导致严重并发症或死亡。白细胞计数升高和血清钠降低与较高的死亡率相关。尽管儿童危重症的生命支持和器官衰竭治疗取得了进展，但百日咳仍有相当高的死亡率。
