Predictors of unfavorable outcomes in enterovirus 71-related cardiopulmonary failure in children

Shao Hsuan Hsia, Chang Teng Wu, Jia Jen Chang, Tzou Yien Lin, Hung Tao Chung, Kuang Lin Lin, Mao Sheng Hwang, Min Liang Chou, Luan Yin Chang

Research output: Contribution to journalArticle

34 Citations (Scopus)

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/μL (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.

Original languageEnglish
Pages (from-to)331-334
Number of pages4
JournalPediatric Infectious Disease Journal
Volume24
Issue number4
DOIs
Publication statusPublished - Apr 2005
Externally publishedYes

Fingerprint

Enterovirus
Mechanical Ventilators
Troponin I
Blood Pressure
Hypoventilation
Deglutition Disorders
Leukocyte Count
Hypotension
Nervous System
Atrophy
Survivors
Cerebrospinal Fluid
Extremities
Physicians

Keywords

  • Cardiopulmonary failure
  • Enterovirus 71
  • Fatality
  • Predictor
  • Sequelae
  • Troponin I

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Predictors of unfavorable outcomes in enterovirus 71-related cardiopulmonary failure in children. / 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.

In: Pediatric Infectious Disease Journal, Vol. 24, No. 4, 04.2005, p. 331-334.

Research output: Contribution to journalArticle

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. / Predictors of unfavorable outcomes in enterovirus 71-related cardiopulmonary failure in children. In: Pediatric Infectious Disease Journal. 2005 ; Vol. 24, No. 4. pp. 331-334.
@article{313b87276270428fae021f8890d1c938,
title = "Predictors of unfavorable outcomes in enterovirus 71-related cardiopulmonary failure in children",
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/μL (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.",
keywords = "Cardiopulmonary failure, Enterovirus 71, Fatality, Predictor, Sequelae, Troponin I",
author = "Hsia, {Shao Hsuan} and Wu, {Chang Teng} and Chang, {Jia Jen} and Lin, {Tzou Yien} and Chung, {Hung Tao} and Lin, {Kuang Lin} and Hwang, {Mao Sheng} and Chou, {Min Liang} and Chang, {Luan Yin}",
year = "2005",
month = "4",
doi = "10.1097/01.inf.0000157219.19674.98",
language = "English",
volume = "24",
pages = "331--334",
journal = "Pediatric Infectious Disease Journal",
issn = "0891-3668",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Predictors of unfavorable outcomes in enterovirus 71-related cardiopulmonary failure in children

AU - Hsia, Shao Hsuan

AU - Wu, Chang Teng

AU - Chang, Jia Jen

AU - Lin, Tzou Yien

AU - Chung, Hung Tao

AU - Lin, Kuang Lin

AU - Hwang, Mao Sheng

AU - Chou, Min Liang

AU - Chang, Luan Yin

PY - 2005/4

Y1 - 2005/4

N2 - 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/μL (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.

AB - 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/μL (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.

KW - Cardiopulmonary failure

KW - Enterovirus 71

KW - Fatality

KW - Predictor

KW - Sequelae

KW - Troponin I

UR - http://www.scopus.com/inward/record.url?scp=17144369122&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=17144369122&partnerID=8YFLogxK

U2 - 10.1097/01.inf.0000157219.19674.98

DO - 10.1097/01.inf.0000157219.19674.98

M3 - Article

C2 - 15818293

AN - SCOPUS:17144369122

VL - 24

SP - 331

EP - 334

JO - Pediatric Infectious Disease Journal

JF - Pediatric Infectious Disease Journal

SN - 0891-3668

IS - 4

ER -