Pertussis requiring intensive care
Objectives: To describe children with pertussis who require intensive care. Design, setting and patients: An audit in Auckland, New Zealand, of pertussis admissions to the national paediatric intensive care unit (PICU) from 1991 to 2003. Results: 72 children, 97% of whom were
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| Veröffentlicht in: | Archives of disease in childhood 2007-11, Vol.92 (11), p.970-975 |
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| creator | Surridge, Julia Segedin, Elizabeth R Grant, Cameron C |
| description | Objectives: To describe children with pertussis who require intensive care. Design, setting and patients: An audit in Auckland, New Zealand, of pertussis admissions to the national paediatric intensive care unit (PICU) from 1991 to 2003. Results: 72 children, 97% of whom were |
| doi_str_mv | 10.1136/adc.2006.114082 |
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| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2083622</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A172113630</galeid><sourcerecordid>A172113630</sourcerecordid><originalsourceid>FETCH-LOGICAL-b563t-9bcc6bb80695f06a79f01717788745c86bda5826051f1b5df45babba244625343</originalsourceid><addsrcrecordid>eNqFkc9LHDEcxYO06NZ67k2WQnsojOZ3MhdBplULUlta296-JNnMGp2d0WRG6n_fDLO4evIUwveTl_e-D6F3BB8QwuShWbgDirHMN4413UIzwqUuKOb8FZphjFlRaq130JuUrjEmVGu2jXaIkoRQVs7Q--8-9kNKIc2jvxtCDO1yHtretync-7kz0b9Fr2vTJL-3PnfR5cmXX9VZcX5x-rU6Pi-skKwvSuuctFZjWYoaS6PKGhNFlNJaceG0tAsjNJVYkJpYsai5sMZaQzmXVDDOdtHRpHs72JVfON_20TRwG8PKxAfoTIDnkzZcwbK7B4o1k5RmgY9rgdjdDT71sArJ-aYxre-GBFJzSiXHL4I0e8y2WAaLCVyaxkNoXZc38693XdP4pYccv7qAY6LoWAYbhQ8n3sUupejrR_cEw8hALgzGwmAqLL_Yfxp6w68bysCHNWCSM00dTetC2nAlybFkubEaUrb4ODfxBqRiSsC33xX8rE4-_1E__sL48aeJt6vrF13-BzQ1uDk</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>20512443</pqid></control><display><type>article</type><title>Pertussis requiring intensive care</title><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Surridge, Julia ; Segedin, Elizabeth R ; Grant, Cameron C</creator><creatorcontrib>Surridge, Julia ; Segedin, Elizabeth R ; Grant, Cameron C</creatorcontrib><description>Objectives: To describe children with pertussis who require intensive care. Design, setting and patients: An audit in Auckland, New Zealand, of pertussis admissions to the national paediatric intensive care unit (PICU) from 1991 to 2003. Results: 72 children, 97% of whom were <12 months old. The annual number of cases increased with time (p = 0.04). Forty patients (56%) were coughing for less than 8 days before admission. Apnoea or paroxysmal cough was present in 33 (83%) of these children. Thirty five (49%) received assisted ventilation. Four died. 19% were readmitted to PICU. Those readmitted presented with more atypical disease and had a shorter first admission but longer total PICU admission (9 vs 5 days, p = 0.009). Of the 58 children from Auckland, nine either died (three) or had subsequent respiratory or neurodevelopmental problems (six). There was an increased risk (relative risk, 95% CI) of death or disability associated with having a co-morbidity (RR = 5.56, 1.50 to 8.15), an elevated lymphocyte count (RR = 5.75, 1.54 to 13.65), presenting with seizures/encephalopathy (4.87, 1.18 to 8.34) or shock (6.50, 1.89 to 8.94), having a PIM score of 1% or more (RR = 6.20, 1.22 to 21.72), any abnormal neurological signs (RR = 9.65, 3.32 to 15.23) or being readmitted to PICU (RR = 4.63, 1.44 to 8.82). Conclusions: Apnoea and paroxysmal cough are key symptoms of pertussis in those with shorter cough duration. Death or disability are frequent. Clinical factors define children at increased risk of these poor outcomes. Early discharge from PICU is associated with an increased risk of readmission and poor outcome.</description><identifier>ISSN: 0003-9888</identifier><identifier>EISSN: 1468-2044</identifier><identifier>DOI: 10.1136/adc.2006.114082</identifier><identifier>PMID: 17611239</identifier><identifier>CODEN: ADCHAK</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</publisher><subject>Anti-Bacterial Agents - therapeutic use ; Apnea - complications ; Apnea - microbiology ; Bacterial diseases ; Biological and medical sciences ; Bradycardia - complications ; Bradycardia - microbiology ; Care and treatment ; Child ; Child, Preschool ; Company business management ; Cyanosis - complications ; Cyanosis - microbiology ; Diagnosis ; Ent and stomatologic bacterial diseases ; General aspects ; Hemolytic-Uremic Syndrome - complications ; Hemolytic-Uremic Syndrome - microbiology ; Human bacterial diseases ; Humans ; Hypertension, Pulmonary - complications ; Hypertension, Pulmonary - microbiology ; Infant ; Infectious diseases ; Intensive Care Units, Pediatric - utilization ; Leukocytosis - complications ; Lymphocytosis - complications ; Male ; Management ; Medical Audit ; Medical sciences ; Miscellaneous ; New Zealand - epidemiology ; Original ; Patient outcomes ; Patient Readmission - statistics & numerical data ; Pediatric intensive care ; Prevention and actions ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Respiration, Artificial - utilization ; Risk factors ; Seizures - complications ; Shock - complications ; Whooping cough ; Whooping Cough - complications ; Whooping Cough - diagnosis ; Whooping Cough - mortality ; Whooping Cough - therapy</subject><ispartof>Archives of disease in childhood, 2007-11, Vol.92 (11), p.970-975</ispartof><rights>2007 BMJ Publishing Group & Royal College of Paediatrics and Child Health</rights><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b563t-9bcc6bb80695f06a79f01717788745c86bda5826051f1b5df45babba244625343</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://adc.bmj.com/content/92/11/970.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://adc.bmj.com/content/92/11/970.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,230,314,727,780,784,885,3194,23569,27922,27923,53789,53791,77370,77401</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19168469$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17611239$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Surridge, Julia</creatorcontrib><creatorcontrib>Segedin, Elizabeth R</creatorcontrib><creatorcontrib>Grant, Cameron C</creatorcontrib><title>Pertussis requiring intensive care</title><title>Archives of disease in childhood</title><addtitle>Arch Dis Child</addtitle><description>Objectives: To describe children with pertussis who require intensive care. Design, setting and patients: An audit in Auckland, New Zealand, of pertussis admissions to the national paediatric intensive care unit (PICU) from 1991 to 2003. Results: 72 children, 97% of whom were <12 months old. The annual number of cases increased with time (p = 0.04). Forty patients (56%) were coughing for less than 8 days before admission. Apnoea or paroxysmal cough was present in 33 (83%) of these children. Thirty five (49%) received assisted ventilation. Four died. 19% were readmitted to PICU. Those readmitted presented with more atypical disease and had a shorter first admission but longer total PICU admission (9 vs 5 days, p = 0.009). Of the 58 children from Auckland, nine either died (three) or had subsequent respiratory or neurodevelopmental problems (six). There was an increased risk (relative risk, 95% CI) of death or disability associated with having a co-morbidity (RR = 5.56, 1.50 to 8.15), an elevated lymphocyte count (RR = 5.75, 1.54 to 13.65), presenting with seizures/encephalopathy (4.87, 1.18 to 8.34) or shock (6.50, 1.89 to 8.94), having a PIM score of 1% or more (RR = 6.20, 1.22 to 21.72), any abnormal neurological signs (RR = 9.65, 3.32 to 15.23) or being readmitted to PICU (RR = 4.63, 1.44 to 8.82). Conclusions: Apnoea and paroxysmal cough are key symptoms of pertussis in those with shorter cough duration. Death or disability are frequent. Clinical factors define children at increased risk of these poor outcomes. Early discharge from PICU is associated with an increased risk of readmission and poor outcome.</description><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Apnea - complications</subject><subject>Apnea - microbiology</subject><subject>Bacterial diseases</subject><subject>Biological and medical sciences</subject><subject>Bradycardia - complications</subject><subject>Bradycardia - microbiology</subject><subject>Care and treatment</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Company business management</subject><subject>Cyanosis - complications</subject><subject>Cyanosis - microbiology</subject><subject>Diagnosis</subject><subject>Ent and stomatologic bacterial diseases</subject><subject>General aspects</subject><subject>Hemolytic-Uremic Syndrome - complications</subject><subject>Hemolytic-Uremic Syndrome - microbiology</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Hypertension, Pulmonary - complications</subject><subject>Hypertension, Pulmonary - microbiology</subject><subject>Infant</subject><subject>Infectious diseases</subject><subject>Intensive Care Units, Pediatric - utilization</subject><subject>Leukocytosis - complications</subject><subject>Lymphocytosis - complications</subject><subject>Male</subject><subject>Management</subject><subject>Medical Audit</subject><subject>Medical sciences</subject><subject>Miscellaneous</subject><subject>New Zealand - epidemiology</subject><subject>Original</subject><subject>Patient outcomes</subject><subject>Patient Readmission - statistics & numerical data</subject><subject>Pediatric intensive care</subject><subject>Prevention and actions</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Respiration, Artificial - utilization</subject><subject>Risk factors</subject><subject>Seizures - complications</subject><subject>Shock - complications</subject><subject>Whooping cough</subject><subject>Whooping Cough - complications</subject><subject>Whooping Cough - diagnosis</subject><subject>Whooping Cough - mortality</subject><subject>Whooping Cough - therapy</subject><issn>0003-9888</issn><issn>1468-2044</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc9LHDEcxYO06NZ67k2WQnsojOZ3MhdBplULUlta296-JNnMGp2d0WRG6n_fDLO4evIUwveTl_e-D6F3BB8QwuShWbgDirHMN4413UIzwqUuKOb8FZphjFlRaq130JuUrjEmVGu2jXaIkoRQVs7Q--8-9kNKIc2jvxtCDO1yHtretync-7kz0b9Fr2vTJL-3PnfR5cmXX9VZcX5x-rU6Pi-skKwvSuuctFZjWYoaS6PKGhNFlNJaceG0tAsjNJVYkJpYsai5sMZaQzmXVDDOdtHRpHs72JVfON_20TRwG8PKxAfoTIDnkzZcwbK7B4o1k5RmgY9rgdjdDT71sArJ-aYxre-GBFJzSiXHL4I0e8y2WAaLCVyaxkNoXZc38693XdP4pYccv7qAY6LoWAYbhQ8n3sUupejrR_cEw8hALgzGwmAqLL_Yfxp6w68bysCHNWCSM00dTetC2nAlybFkubEaUrb4ODfxBqRiSsC33xX8rE4-_1E__sL48aeJt6vrF13-BzQ1uDk</recordid><startdate>20071101</startdate><enddate>20071101</enddate><creator>Surridge, Julia</creator><creator>Segedin, Elizabeth R</creator><creator>Grant, Cameron C</creator><general>BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</general><general>BMJ</general><general>BMJ Publishing Group Ltd</general><general>BMJ Group</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20071101</creationdate><title>Pertussis requiring intensive care</title><author>Surridge, Julia ; Segedin, Elizabeth R ; Grant, Cameron C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b563t-9bcc6bb80695f06a79f01717788745c86bda5826051f1b5df45babba244625343</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Apnea - complications</topic><topic>Apnea - microbiology</topic><topic>Bacterial diseases</topic><topic>Biological and medical sciences</topic><topic>Bradycardia - complications</topic><topic>Bradycardia - microbiology</topic><topic>Care and treatment</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Company business management</topic><topic>Cyanosis - complications</topic><topic>Cyanosis - microbiology</topic><topic>Diagnosis</topic><topic>Ent and stomatologic bacterial diseases</topic><topic>General aspects</topic><topic>Hemolytic-Uremic Syndrome - complications</topic><topic>Hemolytic-Uremic Syndrome - microbiology</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>Hypertension, Pulmonary - complications</topic><topic>Hypertension, Pulmonary - microbiology</topic><topic>Infant</topic><topic>Infectious diseases</topic><topic>Intensive Care Units, Pediatric - utilization</topic><topic>Leukocytosis - complications</topic><topic>Lymphocytosis - complications</topic><topic>Male</topic><topic>Management</topic><topic>Medical Audit</topic><topic>Medical sciences</topic><topic>Miscellaneous</topic><topic>New Zealand - epidemiology</topic><topic>Original</topic><topic>Patient outcomes</topic><topic>Patient Readmission - statistics & numerical data</topic><topic>Pediatric intensive care</topic><topic>Prevention and actions</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Respiration, Artificial - utilization</topic><topic>Risk factors</topic><topic>Seizures - complications</topic><topic>Shock - complications</topic><topic>Whooping cough</topic><topic>Whooping Cough - complications</topic><topic>Whooping Cough - diagnosis</topic><topic>Whooping Cough - mortality</topic><topic>Whooping Cough - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Surridge, Julia</creatorcontrib><creatorcontrib>Segedin, Elizabeth R</creatorcontrib><creatorcontrib>Grant, Cameron C</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Archives of disease in childhood</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Surridge, Julia</au><au>Segedin, Elizabeth R</au><au>Grant, Cameron C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pertussis requiring intensive care</atitle><jtitle>Archives of disease in childhood</jtitle><addtitle>Arch Dis Child</addtitle><date>2007-11-01</date><risdate>2007</risdate><volume>92</volume><issue>11</issue><spage>970</spage><epage>975</epage><pages>970-975</pages><issn>0003-9888</issn><eissn>1468-2044</eissn><coden>ADCHAK</coden><abstract>Objectives: To describe children with pertussis who require intensive care. Design, setting and patients: An audit in Auckland, New Zealand, of pertussis admissions to the national paediatric intensive care unit (PICU) from 1991 to 2003. Results: 72 children, 97% of whom were <12 months old. The annual number of cases increased with time (p = 0.04). Forty patients (56%) were coughing for less than 8 days before admission. Apnoea or paroxysmal cough was present in 33 (83%) of these children. Thirty five (49%) received assisted ventilation. Four died. 19% were readmitted to PICU. Those readmitted presented with more atypical disease and had a shorter first admission but longer total PICU admission (9 vs 5 days, p = 0.009). Of the 58 children from Auckland, nine either died (three) or had subsequent respiratory or neurodevelopmental problems (six). There was an increased risk (relative risk, 95% CI) of death or disability associated with having a co-morbidity (RR = 5.56, 1.50 to 8.15), an elevated lymphocyte count (RR = 5.75, 1.54 to 13.65), presenting with seizures/encephalopathy (4.87, 1.18 to 8.34) or shock (6.50, 1.89 to 8.94), having a PIM score of 1% or more (RR = 6.20, 1.22 to 21.72), any abnormal neurological signs (RR = 9.65, 3.32 to 15.23) or being readmitted to PICU (RR = 4.63, 1.44 to 8.82). Conclusions: Apnoea and paroxysmal cough are key symptoms of pertussis in those with shorter cough duration. Death or disability are frequent. Clinical factors define children at increased risk of these poor outcomes. Early discharge from PICU is associated with an increased risk of readmission and poor outcome.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</pub><pmid>17611239</pmid><doi>10.1136/adc.2006.114082</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; BMJ Journals - NESLi2; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Anti-Bacterial Agents - therapeutic use Apnea - complications Apnea - microbiology Bacterial diseases Biological and medical sciences Bradycardia - complications Bradycardia - microbiology Care and treatment Child Child, Preschool Company business management Cyanosis - complications Cyanosis - microbiology Diagnosis Ent and stomatologic bacterial diseases General aspects Hemolytic-Uremic Syndrome - complications Hemolytic-Uremic Syndrome - microbiology Human bacterial diseases Humans Hypertension, Pulmonary - complications Hypertension, Pulmonary - microbiology Infant Infectious diseases Intensive Care Units, Pediatric - utilization Leukocytosis - complications Lymphocytosis - complications Male Management Medical Audit Medical sciences Miscellaneous New Zealand - epidemiology Original Patient outcomes Patient Readmission - statistics & numerical data Pediatric intensive care Prevention and actions Public health. Hygiene Public health. Hygiene-occupational medicine Respiration, Artificial - utilization Risk factors Seizures - complications Shock - complications Whooping cough Whooping Cough - complications Whooping Cough - diagnosis Whooping Cough - mortality Whooping Cough - therapy |
| title | Pertussis requiring intensive care |
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