• Ta Anh Tuan, Tran Dang Xoay, Noriko Nakajima, Satoshi Nakagawa, Phan Huu Phuc, Dau Viet Hung, Nguyen Trong Dung, Ngo Tien Dong, Tran Ba Dung, Phung Thi Bich Thuy, HaiLe ThanhLTPediatric Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam., and Tran Minh Dien.
• Pediatric Intensive Care Unit, Vietnam National Children's Hospital, Hanoi, Vietnam.
• Pediatr Crit Care Me. 2021 Sep 1; 22 (9): e471e479e471-e479.

ObjectivesPertussis is an infectious disease that causes epidemics and outbreaks and is associated with a high mortality rate, especially in infants, in both developed and developing countries. We aimed to characterize infants with pertussis with respiratory failure and shock and investigated the factors related to mortality.DesignA retrospective, observational study conducted between January 2015 and October 2020.SettingThis study was conducted at the Vietnam National Children's Hospital, which is a government hospital that serves as a tertiary care center in Hanoi, Vietnam.PatientsChildren who fulfilled the following inclusion criteria were included: 1) admitted to the PICU, 2) less than 16 years old, 3) pertussis confirmed by real-time polymerase chain reaction, and 4) treated with mechanical ventilation due to respiratory failure and shock.InterventionsNone.Measurement And Main ResultsSeventy-three mechanically ventilated children (40 boys; median age, 56 d), whereas 19 patients received extracorporeal membrane oxygenation support. Twenty-six patients (36%) died including 12 who received extracorporeal membrane oxygenation. Those who received extracorporeal membrane oxygenation support had higher leukocyte counts upon admission and were more frequently diagnosed with pulmonary hypertension and stage 3 acute kidney injury. Compared with survivors, nonsurvivors showed increased heart rates, leukocyte and neutrophil counts, and lower systolic and diastolic blood pressure at admission. Increased Vasoactive-Inotropic Score, stage 3 acute kidney injury, fluid overload, the use of renal replacement therapy, and extracorporeal membrane oxygenation use were prevalent among nonsurvivors.ConclusionsIn this study, around one third of mechanically ventilated patients with pertussis died. Those who received extracorporeal membrane oxygenation had higher leukocyte counts, a higher prevalence of pulmonary hypertension, and advanced stages of acute kidney injury. Higher Vasoactive-Inotropic Score and advanced stages of acute kidney injury were associated with a greater risk of mortality.Copyright © 2021 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

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