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

Cynthia Howes; Kerith Hiatt; Katherine Turlington; Cortney Foster; Adrian Holloway; Ana Lia Graciano; Jason Custer; Adnan Bhutta; Dayanand Bagdure

doi:10.1055/s-0039-1695045

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

J Pediatr Intensive Care. 2020 Mar;9(1):12-15. doi: 10.1055/s-0039-1695045. Epub 2019 Aug 28.

Authors

Cynthia Howes¹, Kerith Hiatt¹, Katherine Turlington², Cortney Foster², Adrian Holloway², Ana Lia Graciano², Jason Custer², Adnan Bhutta², Dayanand Bagdure²

Affiliations

¹ Department of Pediatrics, Division of Pediatric Critical Care, University of Maryland Medical Center, Baltimore, Maryland, United States.
² Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, United States.

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.

Keywords: botulism; mechanical ventilation; pediatric intensive care unit; pediatrics.