The fluid management and hemodynamic characteristics of PiCCO employed on young children with severe hand, foot, and mouth disease—a retrospective study
Open Access
- 25 February 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Infectious Diseases
- Vol. 21 (1), 1-7
- https://doi.org/10.1186/s12879-021-05889-z
Abstract
Hand, foot, and mouth disease (HFMD) is an acute infectious disease caused by human enterovirus 71 (EV71), coxsackievirus, or echovirus, which is particularly common in preschool children. Severe HFMD is prone to cause pulmonary edema before progressing to respiratory and circulatory failure; thus hemodynamic monitoring and fluid management are important to the treatment process. We did a review of young patients who had been successfully treated in our department for severe HFMD, which had been caused by EV71. A total of 20 patients met the inclusion criteria. Eight cases were monitored by the pulse indicator continuous cardiac output (PiCCO) technique, and fluid management was administered according to its parameters. With regard to the treatment with PiCCO monitoring, patients were divided into two groups: the PiCCO group (8 patients) and the control group (12 patients). The groups were then compared comprehensively to evaluate whether PiCCO monitoring could improve patients’ clinical outcomes. After analysis, the findings informed that although PiCCO failed to shorten the length of ICU stay, reduce the days of vasoactive drug usage, or lower the number of cases which required mechanical ventilation, PiCCO did reduce the incidence of fluid overload (p = 0.085) and shorten the days of mechanical ventilation (p = 0.028). After effective treatment, PiCCO monitoring indicated that the cardiac index (CI) increased gradually(p < 0.0001), in contrast to their pulse (P, p < 0.0001), the extra vascular lung water index (EVLWI, p < 0.0001), the global end diastolic volume index (GEDVI, p = 0.0043), and the systemic vascular resistance index (SVRI, p < 0.0001), all of which decreased gradually. Our study discovered that PiCCO hemodynamic monitoring in young children with severe HFMD has some potential benefits, such as reducing fluid overload and the duration of mechanical ventilation. However, whether it can ameliorate the severity of the disease, reduce mortality, or prevent multiple organ dysfunction remain to be further investigated.Other Versions
Funding Information
- Science and Technology Planning Project of Guangdong Province (2011B031800373)
This publication has 30 references indexed in Scilit:
- Clinical and epidemiological characteristics of Coxsackievirus A6- and Enterovirus 71-associated clinical stage 2 and 3 severe hand, foot, and mouth disease in Guangxi, Southern China, 2017Journal of Infection, 2020
- Development and evaluation of a deep learning approach for modeling seasonality and trends in hand-foot-mouth disease incidence in mainland ChinaScientific Reports, 2019
- Innate Immunity Evasion by Enteroviruses Linked to Epidemic Hand-Foot-Mouth DiseaseFrontiers in Microbiology, 2018
- Chinese guidelines for the diagnosis and treatment of hand, foot and mouth disease (2018 edition)World Journal of Pediatrics, 2018
- Cerebrospinal fluid chemokine patterns in children with enterovirus 71-related encephalitisScientific Reports, 2018
- Epidemiological features and spatio-temporal clusters of hand-foot-mouth disease at town level in Fuyang, Anhui Province, China (2008–2013)Epidemiology and Infection, 2016
- Human enterovirus 71 and hand, foot and mouth diseaseEpidemiology and Infection, 2010
- Bedside assessment of extravascular lung water by dilution methods: Temptations and pitfallsCritical Care Medicine, 2007
- Cardiopulmonary Manifestations of Fulminant Enterovirus 71 InfectionPEDIATRICS, 2002
- Outbreaks of hand, foot, and mouth disease by enterovirus 71. High incidence of complication disorders of central nervous system.Archives of Disease in Childhood, 1980