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

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37 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

Keywords

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

ASJC Scopus subject areas

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

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    Hsia, S. H., Wu, C. T., Chang, J. J., Lin, T. Y., Chung, H. T., Lin, K. L., Hwang, M. S., Chou, M. L., & Chang, L. Y. (2005). Predictors of unfavorable outcomes in enterovirus 71-related cardiopulmonary failure in children. Pediatric Infectious Disease Journal, 24(4), 331-334. https://doi.org/10.1097/01.inf.0000157219.19674.98