Nihal Akcay, Demet Tosun, Ilyas Bingöl, Ibrahim Bingöl, Agop Citak, Süleyman Bayraktar, Mehmet Emin Menetoglu, Esra Sevketoglu, Mey Talip, Nazli Umman Serin, Ceren Bilgül, Ülkem Kocoglu Barlas, Leyla Telhan, Ebru Sahin, Feyza Inceköy Girgin, Mehmet Arda Kilinc Burcu, Bursal, Canan Baydemir
Kanuni Sultan Süleyman Training and Research Hospital and University of Health Sciences. Acıbadem Atakent Hospital and Acıbadem University. Haseki Training and Research Hospital. Bakırköy Dr. Sadi Konuk Training and Research Hospital. Okmeydanı Cemil Taşçıoğlu Training and Research Hospital. Göztepe Prof. Dr. Süleyman Yalçın City Hospital and İstanbul Medeniyet University. İstanbul Medipol University. Sancaktepe Training and Research Hospital. Pendik Training and Research Hospital and Marmara University. Başakşehir Çam Ve Sakura City Hospital. Kocaeli University.
Turkey
European Journal of Pediatrics
Eur J Pediatr 2025; 184:
DOI: 10.1007/s00431-025-05978-0
Abstract
This study aims to evaluate the clinical course of critical pertussis illness to the pediatric intensive care unit in Istanbul. The study was conducted as a multicenter, retrospective study between January 1, 2023, and December 31, 2023. Cases with positive polymerase chain reaction testing for Bordetella pertussis of nasopharyngeal swab samples within the first 24 h of pediatric intensive care unit admission were recorded. We divided the patients into exchange blood transfusion group and non-exchange blood transfusion group, comparing related factors and clinical characteristics among each group. A total of 50 children with severe pertussis were enrolled in the study, including 29 males (58%), with a median age of 9.14 weeks (range, 7.29-15.3 weeks). The mortality rate for severe pertussis was 8%. Exchange blood transfusion was performed in eight patients (16%). There were no significant differences between patients who received exchange blood transfusion and those who did not in terms of age, male gender, gestational age, birth weight, comorbidities, presenting symptoms, duration of cough, prior antibiotic use, vaccination status, coinfections, PICU length of stay, or mortality (p > 0.05). Children who underwent exchange blood transfusion had significantly higher white blood cell (WBC) counts, lymphocyte counts, neutrophil counts, and C-reactive protein (CRP) levels compared to those who did not receive the procedure (p < 0.05). Pulmonary hypertension was observed in 50% of the children who received exchange blood transfusion, while it was present in only 11.8% of those who did not undergo the procedure (p < 0.05). Additionally, patients who received exchange blood transfusion had higher incidences of respiratory failure, cardiac failure or arrest, inotrope requirement, and mechanical ventilation compared to those who did not receive the transfusion (p < 0.05).
Conclusions: Pertussis can lead to severe complications and mortality in critically ill infants. Most severe pertussis occurred in young, unimmunized infants. Children admitted with pertussis with high CRP level, high WBC and lymphocyte, and cardiac and respiratory failure can need exchange blood transfusion.
Category
Class I. Pulmonary Hypertension Associated with Infection
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
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