scholarly journals The fluid management and hemodynamic characteristics of PiCCO employed on young children with severe hand, foot, and mouth disease—a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fengyun Wang ◽  
Xinhua Qiang ◽  
Suhua Jiang ◽  
Jingsong Shao ◽  
Bin Fang ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Young Children ◽  
Hemodynamic Monitoring ◽  
Fluid Overload ◽  
Fluid Management ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Human Enterovirus ◽  
Foot And Mouth ◽  
Picco Monitoring

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 < 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. 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.

scholarly journals The Fluid Management and Hemodynamic Characteristics of PiCCO Employed on Young Children with Severe Hand, Foot, and Mouth Disease—A Retrospective Study

2020 ◽  
Author(s):  
Feng-yun Wang ◽  
Xin-hua Qiang ◽  
Su-hua Jiang ◽  
Jing-song Shao ◽  
Bin Fang ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Young Children ◽  
Hemodynamic Monitoring ◽  
Fluid Overload ◽  
Fluid Management ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Human Enterovirus ◽  
Foot And Mouth ◽  
Picco Monitoring

Abstract Background Hand, foot, and mouth disease (HFMD) is an acute infectious disease caused by human enterovirus 71 (EV71), coxsackievirus, or echovirus, which are particularly common in preschool children. Severe HFMD is prone to pulmonary edema, and successively progresses to respiratory and circulatory failure; thus hemodynamic monitoring and fluid management are important in the treatment process. Methods We reviewed young patients with severe HFMD, caused by EV71, and who had been successfully treated in our department. A total of 20 patients met the inclusion criteria. Some 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 and the control group. The groups were then compared comprehensively to evaluate whether PiCCO monitoring could improve the clinical outcomes. Results After analysis, the findings were that although PiCCO failed to shorten the length of ICU stay, reduce the days of vasoactive drug usage, or reduce the number of cases which needed mechanical ventilation, it did reduce the incidence of fluid overload and shortened the days of mechanical ventilation. After effective treatment, PiCCO monitoring showed that the cardiac index (CI) increased gradually(p<0.0001), whereas the 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 decreased gradually. ConclusionOur study discovered that PiCCO hemodynamic monitoring in young children with severe HFMD has potential clinical benefits which can reduce fluid overload(p=0.085) and duration of mechanical ventilation(p=0.028). However, whether it can ameliorate the severity of the disease, reduce mortality, or prevent multiple organ dysfunction remain to be further investigated.

scholarly journals The fluid management and hemodynamic characteristics of PiCCO employed on young children with severe Hand, Foot, and Mouth Disease—a retrospective study

2020 ◽  
Author(s):  
Fengyun Wang ◽  
Xinhua Qiang ◽  
Suhua Jiang ◽  
Jingsong Shao ◽  
Bin Fang ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Young Children ◽  
Hemodynamic Monitoring ◽  
Fluid Overload ◽  
Fluid Management ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Human Enterovirus ◽  
Foot And Mouth ◽  
Picco Monitoring

Abstract Background Hand, foot, and mouth disease (HFMD) is an acute infectious disease caused by human enterovirus 71 (EV71), coxsackievirus, or echovirus, which are particularly common in preschool children. Severe HFMD is prone to cause pulmonary edema, and successively progresses to respiratory and circulatory failure; thus hemodynamic monitoring and fluid management are important in the treatment process. Methods We reviewed young patients with severe HFMD, caused by EV71, and who had been successfully treated in our department. 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 the clinical outcomes. Results After analysis, the findings were that although PiCCO failed to shorten the length of ICU stay, reduce the days of vasoactive drug usage, or reduce the number of cases which needed mechanical ventilation, it did reduce the incidence of fluid overload (p=0.085) and shortened the days of mechanical ventilation (p=0.028). After effective treatment, PiCCO monitoring showed that the cardiac index (CI) increased gradually(p<0.0001), whereas the 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 decreased gradually. Conclusion Our study discovered that PiCCO hemodynamic monitoring in young children with severe HFMD has potential clinical benefits, such as reducing fluid overload and 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.

scholarly journals Severe enterovirus A71 associated hand, foot and mouth disease, Vietnam, 2018: preliminary report of an impending outbreak

2018 ◽  
Vol 23 (46) ◽  
Author(s):  
Le Nguyen Thanh Nhan ◽  
Nguyen Thi Thu Hong ◽  
Le Nguyen Truc Nhu ◽  
Lam Anh Nguyet ◽  
Nguyen Thi Han Ny ◽  
...  
Keyword(s):  
Young Children ◽  
Preliminary Report ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Referral Hospital ◽  
Ho Chi Minh City ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Enterovirus A71 ◽  
Foot And Mouth

Since January 2018, over 53,000 hospitalisations and six deaths due to hand, foot and mouth disease (HFMD) have occurred across Vietnam with most cases from September onward. In a large tertiary referral hospital, Ho Chi Minh City, enterovirus A71 subgenogroup C4 was predominant, while B5 was only sporadically detected. The re-emergence of C4 after causing a severe HFMD outbreak with > 200 deaths in 2011–12 among susceptible young children raises concern of another impending severe outbreak.

scholarly journals Onychomadesis associated with hand, foot, and mouth disease: a prospective observational study from North Chennai

2020 ◽  
Vol 6 (3) ◽  
pp. 367
Author(s):  
Saraswathy Pichaachari ◽  
Jayanthi Nagappan Subramaniam ◽  
Sajeetha Sundaram
Keyword(s):  
Clinical Diagnosis ◽  
Enterovirus 71 ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Human Enterovirus ◽  
Time Interval ◽  
Benign Condition ◽  
Human Enterovirus 71 ◽  
Foot And Mouth ◽  
Hands And Feet

<p class="abstract"><strong>Background:</strong> Hand, foot, and mouth disease (HFMD) is a common febrile illness caused by coxsackievirus A16 and human enterovirus 71 characterized by vesicular eruptions on hands and feet and enanthem on oral mucosa. Resolves usually without complications but onychomadesis can occur as a late sequlae sometimes.</p><p class="abstract"><strong>Methods:</strong> Children with clinical diagnosis of HFMD between April to June 2018 were included in the study. Age, sex, duration of illness, cutaneous features and nail changes were noted at initial visit and during every week for next 6 weeks.<strong></strong></p><p class="abstract"><strong>Results:</strong> 58 children were recruited in the study with boys to girl’s ratio 1.2:1. The average age was 5.3 years. The vesicular lesions predominantly involved palms and soles (88.3%). 65.5% had history of fever and pruritis was the commonest cutaneous symptom. 27 children (48.21%) developed onychomadesis during follow up with average time interval of 3.2 weeks between the clinical diagnosis and nail shedding. Reassurance about spontaneous resolution of the condition given to the parents.</p><p class="abstract"><strong>Conclusions:</strong> Our study strengthened the association between the HFMD and occurrence of onychomadesis. Physician’s awareness about this benign condition is needed to avoid parental anxiety, unnecessary investigations and treatment for the children.   </p>

scholarly journals Hand, Foot and Mouth Disease (HFMD): An Update

2017 ◽  
Vol 40 (2) ◽  
pp. 115-119 ◽  
Author(s):  
Probir Kumar Sarkar ◽  
Nital Kumar Sarker ◽  
Md Abu Tayab
Keyword(s):  
Enterovirus 71 ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Coxsackie Virus ◽  
Asia Pacific ◽  
Human Enterovirus ◽  
Small Scale ◽  
Human Enterovirus 71 ◽  
Mild Disease ◽  
Foot And Mouth

Hand, foot, and mouth disease (HFMD) also known as vesicular stomatitis with exanthema, first reported in New Zealand in 1957 is caused by Coxsackie virus A16 (CVA16), human enterovirus 71 (HEV71) and occasionally by other HEV-A serotypes, such as Coxsackie virus A6 and Coxsackie virus A10, are also associated with HFMD and herpangina. While all these viruses can cause mild disease in children, EV71 has been associated with neurological disease and mortality in large outbreaks in the Asia Pacific region over the last decade. It is highly contagious and is spread through direct contact with the mucus, saliva, or feces of an infected person. This is characterized by erythrematous papulo vesicular eruptions over hand, feet, perioral area, knee, buttocks and also intra-orally mostly in children, typically occurs in small epidemics usually during the summer and autumn months. HFMD symptoms are usually mild and resolve on their own in 7 to 10 days. Treatment is symptomatic but good hygiene during and after infection is very important in preventing the spread of the disease. Though only small scale outbreaks have been reported from United States, Europe, Australia Japan and Brazil for the first few decade, since 1997 the disease has conspicuously changed its behavior as noted in different Southeast Asian countries. There was sharp rise in incidence, severity, complications and even fatal outcomes that were almost unseen before that period. There are reports of disease activity in different corners of India since 2004, and the largest outbreak of HFMD occurred in eastern part of India in and around Kolkata in 2007and Bhubaneswar, Odisha in 2009. In recent years there are cases of HFMD have been seen in Bangladesh also. Although of milder degree, continuous progress to affect larger parts of the neighboring may indicate vulnerability of Bangladesh from possible future outbreaks.Bangladesh J Child Health 2016; VOL 40 (2) :115-119

scholarly journals Gambaran Klinis dan Karakteristik Genetik Human Enterovirus 71 Penyebab Hand Foot and Mouth Disease di Banjarmasin – Kalimantan Selatan Tahun 2016

Sari Pediatri ◽  
2020 ◽  
Vol 21 (5) ◽  
pp. 271
Author(s):  
Edi Hartoyo
Keyword(s):  
Enterovirus 71 ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Human Enterovirus ◽  
Human Enterovirus 71 ◽  
Foot And Mouth

Latar belakang. Hand foot and mouth desease (HFMD) adalah infeksi virus akut yang biasanya menyerang anak dibawah 10 tahun, sangat menular dan dapat menimbulkan komplikasi fatal. Tujuan. Untuk mengetahui gejala klinis, komplikasi, dan serotipe penyebab HFMD di Banjarmasin. Metode. Penelitian deskriptif, sampel diambil di poliklinik RSUD Ulin dan RS. Islam Banjarmasin periode November 2015 sampai dengan Febuari 2016 yang terdiagnosis HFMD oleh dokter spesialis anak, terdapat 23 sampel.Hasil. Dari 23 pasien secara klinis HFMD terdapat 18 (78%) positif entero virus, 71, 2 (9%) positif campak, dan 3 (13%) negatif. Umur rata rata ±20,77 bulan, laki laki 12 (52%) dan perempuan 11 (48%). Gejala klinis demam 17 (74%), rash/ lesi kulit 23 (100%), susah makan 14(61%), batuk 8(35%), pilek 9(39%), diare 5(22%), konjungtivitis 2(9%), muntah 4(17%), nyeri menelan 14(61%), dan kenjang 2(9%).Kesimpulan. Penyebab HFMD terbanyak adalah EV71, umur tesering kurang dari 3 tahun, gejala klinis terbanyak lesi kulit, demam dan tidak didapatkan komplikasi serius (intakranial).

scholarly journals Epidemiology of hand, foot and mouth disease in China, 2008 to 2015 prior to the introduction of EV-A71 vaccine

2017 ◽  
Vol 22 (50) ◽  
Author(s):  
Bingyi Yang ◽  
Fengfeng Liu ◽  
Qiaohong Liao ◽  
Peng Wu ◽  
Zhaorui Chang ◽  
...  
Keyword(s):  
Enterovirus 71 ◽  
Foot And Mouth Disease ◽  
Incidence Rates ◽  
Mouth Disease ◽  
Human Enterovirus ◽  
Coxsackievirus A16 ◽  
Serotype Replacement ◽  
Foot And Mouth ◽  
Vaccine Impact ◽  
National Surveillance System

Introduction Hand, foot and mouth disease (HFMD) is usually caused by several serotypes from human enterovirus A species, including enterovirus 71 (EV-A71) and coxsackievirus A16 (CV-A16). Two inactivated monovalent EV-A71 vaccines have been recently licensed in China and monovalent CV-A16 vaccine and bivalent EV-A71 and CV-A16 vaccine are under development. Methods: Using notifications from the national surveillance system, we describe the epidemiology and dynamics of HFMD in the country, before the introduction of EV-A71 vaccination, from 2008 through 2015. Results: Laboratory-identified serotype categories, i.e. CV-A16, EV-A71 and other enteroviruses, circulated annually. EV-A71 remained the most virulent serotype and was the major serotype for fatal cases (range: 88.5–95.4%) and severe cases (range: 50.7–82.3%) across years. Except for 2013 and 2015, when other enteroviruses were more frequently found in mild HFMD (48.8% and 52.5%), EV-A71 was more frequently detected from mild cases in the rest of the years covered by the study (range: 39.4–52.6%). The incidence rates and severity risks of HFMD associated with all serotype categories were the highest for children aged 1 year and younger, and decreased with increasing age. Discussion/conclusion: This study provides baseline epidemiology for evaluation of vaccine impact and potential serotype replacement.

The epidemiological and clinical characteristics of hand, foot and mouth disease in Hangzhou, China, 2016-2018

2019 ◽  
Author(s):  
Jie Wang ◽  
Jun Zhou ◽  
Guoliang Xie ◽  
Shufa Zheng ◽  
Bin Lou ◽  
...  
Keyword(s):  
Clinical Status ◽  
Enterovirus 71 ◽  
Foot And Mouth Disease ◽  
Mouth Disease ◽  
Human Enterovirus ◽  
Rt Pcr ◽  
Foot And Mouth ◽  
Epidemiological Characteristics ◽  
The Relationship ◽  
Children Under 5

Abstract Background Hand, foot and mouth disease (HFMD) is most frequently caused by several serotypes of human enterovirus (EV) including Enterovirus 71 (EV71), Coxsackievirus A16 (CV-A16) or other types of EV. Children under 5 years old are the most susceptible to HFMD. The aim of this study was to determine the epidemiological characteristics and the relationship between severe and mild HFMD. Methods We collected 4760 probable HFMD cases with skin papular or vesicular rashes on the hands, feet, mouth or buttocks in Hangzhou from 2016 to 2018. Specimens of these cases were collected and the pathogen of EV71, CV-A16, CV-A6, CV-A10, CV-A2 and CV-A5 was classified by RT-PCR. Then the pathogen distribution and clinical status of children with HFMD were described. Results From Jan. 1, 2016 to Dec. 31, 2018, the incidence and prevalence of HFMD were seasonal each year. Among the 4760 probable HFMD cases, 3559 cases were confirmed (74.8%, 3559/4760), including 426 cases of EV71 infections (8.9%, 426/4760, 249 cases of CV-A16 infections (5.2%, 249/4760) and 2884 cases of other enteroviruses infections (60.6%, 2884/4760). The percentage of EV positive HFMD cases with non-EV71 and non-CV-A16 was more than 80% (2884/3559), which increased year by year. The percentage of EV71 decreased year by year in the last three years especially in 2018. Among the 1297 cases randomly selected of other EV infections in 2017 and 2018, there were 835 (64.4%) cases of CV-A6 infections, 177 (13.6%) cases of CV-A10 infections, 100 (7.7%) cases of CV-A2 infections, 40 (3.1%) cases of CV-A5 infections, 3 (0.02%) cases of mixed infections and 11.0% untyped enteroviruses infections. Preschool children were still the primary population susceptible to HFMD, and the age of the children infected with other enteroviruses tended to be younger. In severe cases, EV71 infection was the main cause. Conclusions The other EV especially CV-A6 increased obviously and EV71 decreased obviously in the three years. Characterizing the epidemiology and the relationship between severe and common cases of HFMD would provide relevant evidences for the prevention and treatment of HFMD.

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