Cardiopulmonary failure in children infected with Enterovirus A71
Open Access
- 16 April 2020
- journal article
- review article
- Published by Springer Science and Business Media LLC in Journal of Biomedical Science
- Vol. 27 (1), 1-6
- https://doi.org/10.1186/s12929-020-00650-1
Abstract
Enterovirus A71 (EV-A71) is one of the causative pathogens of hand, foot, and mouth disease (HFMD), which may cause severe neurological and cardiopulmonary complications in children. In this review, we discuss the pathogenesis, clinical manifestations, management strategy, and clinical outcomes of cardiopulmonary failure (CPF) in patients with EV-A71 infection. The pathogenesis of CPF involves both catecholamine-related cardiotoxicity following brainstem encephalitis and vasodilatory shock due to cytokine storm. Sympathetic hyperactivity, including tachycardia and hypertension, are the early clinical manifestations of cardiopulmonary involvement, which may progress to pulmonary edema/hemorrhage and/or CPF. The management strategy comprises multidisciplinary supportive treatment, including fluid management, positive pressure ventilation support, and use of milrinone, vasopressors, and inotropes. Some patients may require extracorporeal membrane oxygenation. Major neurological sequelae are almost inevitable once a child develops life-threatening illness. Long-term care of these children is an important medico-social issue.Keywords
This publication has 37 references indexed in Scilit:
- The role of catecholamines in the pathogenesis of neurogenic pulmonary edema associated with subarachnoid hemorrhageActa Neurochirurgica, 2012
- Clinical features, diagnosis, and management of enterovirus 71The Lancet Neurology, 2010
- High frequency oscillation in patients with acute lung injury and acute respiratory distress syndrome (ARDS): systematic review and meta-analysisBMJ, 2010
- Neurodevelopment and Cognition in Children after Enterovirus 71 InfectionThe New England Journal of Medicine, 2007
- Critical management in patients with severe enterovirus 71 infectionPediatrics International, 2006
- Therapeutic efficacy of milrinone in the management of enterovirus 71‐induced pulmonary edemaPediatric Pulmonology, 2005
- The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and AdolescentsPEDIATRICS, 2004
- Outbreak of enterovirus 71 infection in Victoria, Australia, with a high incidence of neurologic involvementThe Pediatric Infectious Disease Journal, 1988
- NURSING CARE OF THE CRITICALLY ILL CHILDThe American Journal of Nursing, 1984
- Virological diagnosis of enterovirus type 71 infections: Experiences gained during an epidemic of acute CNS diseases in Hungary in 1978Archiv für die gesamte Virusforschung, 1982