ECLS in pertussis: does it have a role?
OBJECTIVE
To investigate the value of extracorporeal circulatory life support (ECLS) in paediatric patients with severe Bordetella pertussis infection.


METHODS
Single case report and a review of the ECLS database.


METHODS
Tertiary referral hospital paediatric intensive care unit.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Williams
G D
GD
Children's Intensive Care Unit, Sydney Children's Hospital, Randwick, NSW, Australia. G.Williams@unsw.edu.au
Numa
A
A
Sokol
J
J
Tobias
V
V
Duffy
B J
BJ
D004200:Diseases in Twins; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D017809:Fatal Outcome; D006801:Humans; D007223:Infant; D008297:Male; D011659:Pulmonary Gas Exchange; D012042:Registries; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014917:Whooping Cough / Q000473:pathology / Q000628:therapy*