In the most severe cases of pertussis [whooping cough] in infants the children suffer high white blood cell counts which leads to low oxygen levels and high blood pressure in the lungs - probably because blood becomes too viscous. A paper in Pediatrics** shows that the practice at Great Ormond Street Hospital for Children for Children on intensive care significantly reduces mortality. The hospital is the largest intensive care unit for children in the UK and therefore sees a significant proportion of the very sickest pertussis cases.
We use 'exchange transfusions' or special blood filters to reduce white blood cell count. A full randomised controlled trial was not possible because of the small number of cases but we evaluated removing the white cells against historic data. With this regimen survival rates of the children greatly improved (1 death in 10 as opposed to a predicted mortality of 4-5 deaths/10)
Dr Mark Peters, Consultant Intensivist at Great Ormond Street Hospital for Children, said “Pertussis is an avoidable illness because of immunisation. Infants are vulnerable, and there is no effective vaccination in this age group, the best preventative is for all older children and adults to be immunised, protecting the infants through herd immunity. The severity of this complication of pertussis shows that public and professionals should unequivocally support pertussis vaccination.”
**RE: 2009-2860.R2 - Impact of Rapid Leukodepletion on the Outcome of
Severe Clinical Pertussis in Young Infants (Pediatrics)
Published online 12.00 Eastern Time Monday 6 Sept.
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