Yan Liu, Yaoyao Wu, Wei Yue, Xinyan Qiu
Guangdong Women and Children Hospital.
China
International Journal of Emergency Medicine
Int J Emerg Med 2026;
DOI: 10.1186/s12245-026-01247-5
Abstract
Background: Severe pertussis in young infants can lead to respiratory failure, pulmonary hypertension, and sepsis, and remains difficult to manage when conventional therapies fail. In such cases, extracorporeal membrane oxygenation (ECMO) combined with airway clearance techniques (ACT) may help stabilize cardiopulmonary function and relieve airway obstruction.
Case presentation: We report a case of a two-month-old female infant diagnosed with severe pertussis, presenting with acute respiratory failure, pulmonary hypertension, and refractory sepsis. Laboratory findings revealed significant leukocytosis (WBC: 67.56 × 10⁹/L) and elevated cardiac biomarkers. Despite leukoreduction and escalating respiratory support, the patient developed persistent hypoxemia and hemodynamic instability, indicating progressive cardiorespiratory failure. Venoarterial extracorporeal membrane oxygenation was initiated for cardiopulmonary support. Concurrent airway clearance techniques, including prone positioning, nebulised therapy, and bronchoscopic secretion removal, were implemented to manage severe airway obstruction. The patient showed progressive improvement in oxygenation and pulmonary hypertension during ECMO support, with successful decannulation after 163 h and discharge after 25 days of hospitalization, without major complications.
Conclusions: This case shows that early ECMO, when combined with structured airway clearance, may be beneficial in selected high-risk infants. Further studies are required to further validate the role of this combined approach.
Category
Class I. Pulmonary Hypertension Associated with Infection
Surgical and Catheter-mediated Interventions for Pulmonary Vascular Disease
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes