Predictors of Unfavorable Outcomes in Enterovirus 71-Related Cardiopulmonary Failure in Children
Resource
PEDIATRIC INFECTIOUS DISEASE JOURNAL v.24 n.4 pp.331-334
Journal
PEDIATRIC INFECTIOUS DISEASE JOURNAL
Journal Volume
v.24
Journal Issue
n.4
Pages
331-334
Date Issued
2005
Date
2005
Author(s)
Hsia, Shao-Hsuan
Wu, Chang-Teng
Chang, Jia-Jen
Lin, Tzou-Yien
Chung, Hung-Tao
Lin, Kuang-Lin
Hwang, Mao-Sheng
Chou, Min-Liang
Chang, Luan-Yin
Abstract
Background: Enterovirus 71 (EV71) can sometimes cause fatal or disabling diseases in children; therefore EV71-infected children with cardiopulmonary failure were investigated at Chang Gung Children's Hospital to discover the prognostic predictors. Methods: We investigated 27 EV71-infected children with cardiopulmonary failure from May 2000 to September 2001 and analyzed their clinical data to find predictors associated with unfavorable outcomes of deaths or ventilator dependence. Results: Of the 27 patients, 8 (30%) died and 10 (37%) were ventilator- dependent. Troponin I levels correlated most strongly with fatality, with 5 of the 6 children with troponin I levels >40 ng/ml dying (P = 0. 001). Other factors correlated with fatality were cerebrospinal fluid white blood cell count >=100/[mu]L (P = 0.002) and initial systolic pressure <= 100 mm Hg (P = 0.05). Of the 19 survivors, 10 (53%) were left with central hypoventilation, dysphagia and/or limb weakness plus atrophy . The factors associated with ventilator dependence included higher inotrope equivalent (P < 0.001), duration of hypotension >=40 hours, initial blood systolic pressure <= 100 mm Hg, positive EV71 isolation and age >=12 months. Conclusions: Poor prognostic factors were related to cardiovascular and neurologic damage; therefore physicians may consider advanced cardiovascular support for EV71- infected children with cardiopulmonary failure.(C) 2005 Lippincott Williams & Wilkins, Inc.
Subjects
Enterovirus 71
Cardiopulmonary Failure
Predictor
Troponin I
fatality
sequelae
Type
journal article