Williams G D, Numa A, Sokol J, Tobias V, Duffy B J
Children's Intensive Care Unit, Sydney Children's Hospital, Randwick, NSW, Australia.
Intensive Care Med. 1998 Oct;24(10):1089-92. doi: 10.1007/s001340050721.
To investigate the value of extracorporeal circulatory life support (ECLS) in paediatric patients with severe Bordetella pertussis infection.
Single case report and a review of the ECLS database.
Tertiary referral hospital paediatric intensive care unit.
A single case report of an infant with B. pertussis infection is described. Despite receiving ECLS, this infant died from overwhelming cardiac and cerebral insults. Outcome for children receiving ECLS registered on the Extracorporeal Life Support Organization database is reviewed.
The mortality of infants receiving ECLS for B. pertussis infection is high, with only 5 survivors reported among 22 registered cases. The majority of nonsurvivors had evidence of circulatory collapse in addition to severe respiratory failure, and these patients commonly died of hypoxic-ischaemic cerebral insult. These data suggest the existence of a subgroup of patients with respiratory failure only, who may benefit from ECLS, and a larger subgroup who suffer ischaemic cardiac and cerebral insults which are unlikely to be improved by ECLS.
The value of ECLS in patients with B. pertussis infection who present with major cardiac dysfunction is questionable. Such patients almost invariably have a poor outcome despite maximal therapy.
探讨体外循环生命支持（ECLS）在重症百日咳博德特氏菌感染儿科患者中的价值。
单病例报告及ECLS数据库回顾。
三级转诊医院儿科重症监护病房。
描述了1例百日咳博德特氏菌感染婴儿的单病例报告。尽管接受了ECLS治疗，该婴儿仍死于严重的心脏和脑部损伤。回顾了体外生命支持组织数据库中登记的接受ECLS治疗儿童的结局。
接受ECLS治疗的百日咳博德特氏菌感染婴儿死亡率很高，在22例登记病例中仅报告了5例存活者。大多数非存活者除严重呼吸衰竭外还有循环衰竭的证据，这些患者通常死于缺氧缺血性脑损伤。这些数据表明存在仅患有呼吸衰竭的患者亚组，他们可能从ECLS中获益，以及更大的一组患有缺血性心脏和脑损伤的患者亚组，这些损伤不太可能通过ECLS得到改善。
ECLS在伴有严重心脏功能障碍的百日咳博德特氏菌感染患者中的价值值得怀疑。尽管进行了最大程度的治疗，这类患者几乎总是预后不良。
