J Pediatr Intensive Care 2020; 09(01): 012-015
DOI: 10.1055/s-0039-1695045
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Botulism in the Pediatric Intensive Care Units in the United States: Interrogating a National Database

Cynthia Howes
1   Department of Pediatrics, Division of Pediatric Critical Care, University of Maryland Medical Center, Baltimore, Maryland, United States
,
Kerith Hiatt
1   Department of Pediatrics, Division of Pediatric Critical Care, University of Maryland Medical Center, Baltimore, Maryland, United States
,
Katherine Turlington
2   Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, United States
,
2   Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, United States
,
Adrian Holloway
2   Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, United States
,
Ana Lia Graciano
2   Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, United States
,
Jason Custer
2   Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, United States
,
2   Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, United States
,
Dayanand Bagdure
2   Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, United States
› Author Affiliations
Further Information

Publication History

18 May 2019

11 July 2019

Publication Date:
28 August 2019 (online)

Abstract

Botulism in children can have severe complications necessitating intensive care. The current literature lacks data of children with botulism requiring critical care. We aim to describe the outcomes of pediatric botulism in the pediatric intensive care unit (PICU). Retrospective cohort data from Virtual Pediatric Systems (VPS, LLC, Los Angeles, California), from 2009 to 2016 including all PICU admissions among children with botulism, were analyzed. Characteristics and outcomes were compared with similar studies. A total of 380 children were identified over 8 years. Our cohort had the shortest length of stay (median 4.6 days), the smallest percent requiring mechanical ventilation (40%), and the highest median age (120 days) amongst comparable studies. Length of mechanical ventilation and PICU stay has decreased among children with botulism. Advances in PICU care may have contributed to these improved outcomes.

 
  • References

  • 1 Carrillo-Marquez MA. Botulism. Pediatr Rev 2016; 37 (05) 183-192
  • 2 Centers of Disease Control. National Botulism Surveillance, Annual Summaries. Available at: https://www.cdc.gov/nationalsurveillance/pdfs/botulism_cste_2015.pdf . Accessed: July 30, 2019
  • 3 Underwood K, Rubin S, Deakers T, Newth C. Infant botulism: a 30-year experience spanning the introduction of botulism immune globulin intravenous in the intensive care unit at Childrens Hospital Los Angeles. Pediatrics 2007; 120 (06) e1380-e1385
  • 4 Arnon SS, Schechter R, Maslanka SE, Jewell NP, Hatheway CL. Human botulism immune globulin for the treatment of infant botulism. N Engl J Med 2006; 354 (05) 462-471
  • 5 Tseng-Ong L, Mitchell WG. Infant botulism: 20 years' experience at a single institution. J Child Neurol 2007; 22 (12) 1333-1337
  • 6 Goh CT, Kirby LJ, Schell DN, Egan JR. Humidified high-flow nasal cannula oxygen in bronchiolitis reduces need for invasive ventilation but not intensive care admission. J Paediatr Child Health 2017; 53 (09) 897-902
  • 7 Yañez LJ, Yunge M, Emilfork M. , et al. A prospective, randomized, controlled trial of noninvasive ventilation in pediatric acute respiratory failure. Pediatr Crit Care Med 2008; 9 (05) 484-489
  • 8 Padman R, Lawless ST, Kettrick RG. Noninvasive ventilation via bilevel positive airway pressure support in pediatric practice. Crit Care Med 1998; 26 (01) 169-173
  • 9 Randolph AG, Meert KL, O'Neil ME. , et al; Pediatric Acute Lung Injury and Sepsis Investigators Network. The feasibility of conducting clinical trials in infants and children with acute respiratory failure. Am J Respir Crit Care Med 2003; 167 (10) 1334-1340
  • 10 Wheeler DS, Whitt JD, Lake M, Butcher J, Schulte M, Stalets E. A case-control study on the impact of ventilator-associated tracheobronchitis in the PICU. Pediatr Crit Care Med 2015; 16 (06) 565-571
  • 11 Saliski M, Kudchadkar SR. Optimizing sedation management to promote early mobilization for critically ill children. J Pediatr Intensive Care 2015; 4 (04) 188-193
  • 12 Shibata S, Khemani RG, Markovitz B. Patient origin is associated with duration of endotracheal intubation and PICU length of stay for children with status asthmaticus. J Intensive Care Med 2014; 29 (03) 154-159