1. The fluid management and hemodynamic characteristics of PiCCO employed on young children with severe hand, foot, and mouth disease—a retrospective study
- Author
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Jingsong Shao, Suhua Jiang, Xinhua Qiang, Bin Fang, Fengyun Wang, and Lixin Zhou
- Subjects
0301 basic medicine ,Male ,Cardiac output ,medicine.medical_treatment ,Cardiac index ,Hemodynamics ,Pulmonary Edema ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,0302 clinical medicine ,Heart Rate ,medicine ,Fluid management ,Humans ,lcsh:RC109-216 ,030212 general & internal medicine ,Cardiac Output ,Pulse indicator continuous cardiac output ,Monitoring, Physiologic ,Retrospective Studies ,Mechanical ventilation ,business.industry ,Organ dysfunction ,Infant ,Retrospective cohort study ,Pulmonary edema ,medicine.disease ,Enterovirus A, Human ,Acute pulmonary edema ,Hand, foot, and mouth disease ,030104 developmental biology ,Infectious Diseases ,medicine.anatomical_structure ,Treatment Outcome ,Anesthesia ,Child, Preschool ,Vascular resistance ,Fluid Therapy ,Female ,Enterovirus 71 ,medicine.symptom ,business ,Hand, Foot and Mouth Disease ,Research Article - Abstract
Background 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. Methods 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. Results 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 p 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. Conclusion 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.
- Published
- 2021