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Master Thesis

Évaluation de la tolérance de la leucoréduction chez les patients atteints de coqueluche maligne admis en réanimation pédiatrique au Kremlin Bicêtre de 2001 à 2018

Abstract : Pertussis remains a life-threatening disease in children under 3 months of age without vaccination. Cardio-respiratory failures and pulmonary hypertention in severe pertussis are believed to be linked to white blood cell aggregates in lung microvasculature. Leukodepletion, by fighting against this accumulation, seems to improve those patients survival rate in various publications. The purpose of this retrospective monocentric study is to assess the tolerance of leukodepletion and the risk factor of death among patients hospitalized in Kremlin Bicêtre ICU for pertussis from 2001 to 2018. 60 children were hospitalized for pertussis during this period. 8 died, representing a mortality rate of 13.3%. The main risk factors for deaths were young age (p=0.006), small weight (p=0.025), tachycardia (p=0.024), peripheral hypoperfusion (p<0.001), respiratory distress (p=0.006), acidosis (p=0.039), and pulmonary hypertention (p<0.001). The use of vasoactive drips (p<0.001), mecanical ventilation (p<0.001) and exchange transfusion (p<0.001) are associated with death. Among the 9 exsanguinated patients, the mortality rate is 66.6%. Before/after the procedure, there was a significant increase in the saturation/Fio2 ratio (p=0.035) and a decrease in PvCO2 (p=0.014) as well as the rate of leukocytes (62.1% on average, p<0.001). The side effects of this procedure are a decrease in calcemia (p=0.035) and platelets (p<0.001). Given the fact that this procedure does not require specific equipment, seems well tolerated and improves the prognosis of theses patients in various publications, exchange transfusion seems to be a necessary option in the management of severe pertussis.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03129841
Contributor : Université Paris Descartes - Scd <>
Submitted on : Wednesday, February 3, 2021 - 10:12:39 AM
Last modification on : Wednesday, June 9, 2021 - 3:22:29 AM

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Caroline Caula. Évaluation de la tolérance de la leucoréduction chez les patients atteints de coqueluche maligne admis en réanimation pédiatrique au Kremlin Bicêtre de 2001 à 2018. Médecine humaine et pathologie. 2019. ⟨dumas-03129841⟩

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