Hemorrhagic shock and encephalopathy syndrome – the markers for an early HSES diagnosis
<p>Abstract</p> <p>Background</p> <p>The hemorrhagic shock and encephalopathy syndrome (HSES) is a devastating disease that affects young children. The outcomes of HSES patients are often fatal or manifesting severe neurological sequelae. We reviewed the markers for an...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2008-10-01
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| Series: | BMC Pediatrics |
| Online Access: | http://www.biomedcentral.com/1471-2431/8/43 |
| _version_ | 1818001070248427520 |
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| author | Miyaichi Toshinori Arimoto Hideki Miyazaki Dai Kan Masanori Yoshimoto Akira Fuke Akihiro Tsuruwa Miho Kubota Tetsushi Yoshida Takeshi Rinka Hiroshi Kaji Arito Miyamoto Satoru Kuki Ichiro Shiomi Masashi |
| author_facet | Miyaichi Toshinori Arimoto Hideki Miyazaki Dai Kan Masanori Yoshimoto Akira Fuke Akihiro Tsuruwa Miho Kubota Tetsushi Yoshida Takeshi Rinka Hiroshi Kaji Arito Miyamoto Satoru Kuki Ichiro Shiomi Masashi |
| author_sort | Miyaichi Toshinori |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>The hemorrhagic shock and encephalopathy syndrome (HSES) is a devastating disease that affects young children. The outcomes of HSES patients are often fatal or manifesting severe neurological sequelae. We reviewed the markers for an early diagnosis of HSES.</p> <p>Methods</p> <p>We examined the clinical, biological and radiological findings of 8 patients (4 months to 9 years old) who met the HSES criteria.</p> <p>Results</p> <p>Although cerebral edema, disseminated intravascular coagulopathy (DIC), and multiple organ failure were seen in all 8 cases during their clinical courses, brain computed tomography (CT) scans showed normal or only slight edema in 5 patients upon admission. All 8 patients had normal platelet counts, and none were in shock. However, they all had severe metabolic acidosis, which persisted even after 3 hours (median base excess (BE), -7.6 mmol/L). And at 6 hours after admission (BE, -5.7 mmol/L) they required mechanical ventilation. Within 12 hours after admission, fluid resuscitation and vasopressor infusion for hypotension was required. Seven of the patients had elevated liver enzymes and creatine kinase (CK) upon admission. Twenty-four hours after admission, all 8 patients needed vasopressor infusion to maintain blood pressure.</p> <p>Conclusion</p> <p>CT scan, platelet count, hemoglobin level and renal function upon admission are not useful for an early diagnosis of HSES. However, the elevated liver enzymes and CK upon admission, hypotension in the early stage after admission with refractory acid-base disturbance to fluid resuscitation and vasopressor infusion are useful markers for an early HSES diagnosis and helpful to indicate starting intensive neurological treatment.</p> |
| first_indexed | 2024-04-14T03:29:55Z |
| format | Article |
| id | doaj.art-37ee99ae137e4cac8848bec84434e48b |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-04-14T03:29:55Z |
| publishDate | 2008-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-37ee99ae137e4cac8848bec84434e48b2022-12-22T02:15:00ZengBMCBMC Pediatrics1471-24312008-10-01814310.1186/1471-2431-8-43Hemorrhagic shock and encephalopathy syndrome – the markers for an early HSES diagnosisMiyaichi ToshinoriArimoto HidekiMiyazaki DaiKan MasanoriYoshimoto AkiraFuke AkihiroTsuruwa MihoKubota TetsushiYoshida TakeshiRinka HiroshiKaji AritoMiyamoto SatoruKuki IchiroShiomi Masashi<p>Abstract</p> <p>Background</p> <p>The hemorrhagic shock and encephalopathy syndrome (HSES) is a devastating disease that affects young children. The outcomes of HSES patients are often fatal or manifesting severe neurological sequelae. We reviewed the markers for an early diagnosis of HSES.</p> <p>Methods</p> <p>We examined the clinical, biological and radiological findings of 8 patients (4 months to 9 years old) who met the HSES criteria.</p> <p>Results</p> <p>Although cerebral edema, disseminated intravascular coagulopathy (DIC), and multiple organ failure were seen in all 8 cases during their clinical courses, brain computed tomography (CT) scans showed normal or only slight edema in 5 patients upon admission. All 8 patients had normal platelet counts, and none were in shock. However, they all had severe metabolic acidosis, which persisted even after 3 hours (median base excess (BE), -7.6 mmol/L). And at 6 hours after admission (BE, -5.7 mmol/L) they required mechanical ventilation. Within 12 hours after admission, fluid resuscitation and vasopressor infusion for hypotension was required. Seven of the patients had elevated liver enzymes and creatine kinase (CK) upon admission. Twenty-four hours after admission, all 8 patients needed vasopressor infusion to maintain blood pressure.</p> <p>Conclusion</p> <p>CT scan, platelet count, hemoglobin level and renal function upon admission are not useful for an early diagnosis of HSES. However, the elevated liver enzymes and CK upon admission, hypotension in the early stage after admission with refractory acid-base disturbance to fluid resuscitation and vasopressor infusion are useful markers for an early HSES diagnosis and helpful to indicate starting intensive neurological treatment.</p>http://www.biomedcentral.com/1471-2431/8/43 |
| spellingShingle | Miyaichi Toshinori Arimoto Hideki Miyazaki Dai Kan Masanori Yoshimoto Akira Fuke Akihiro Tsuruwa Miho Kubota Tetsushi Yoshida Takeshi Rinka Hiroshi Kaji Arito Miyamoto Satoru Kuki Ichiro Shiomi Masashi Hemorrhagic shock and encephalopathy syndrome – the markers for an early HSES diagnosis BMC Pediatrics |
| title | Hemorrhagic shock and encephalopathy syndrome – the markers for an early HSES diagnosis |
| title_full | Hemorrhagic shock and encephalopathy syndrome – the markers for an early HSES diagnosis |
| title_fullStr | Hemorrhagic shock and encephalopathy syndrome – the markers for an early HSES diagnosis |
| title_full_unstemmed | Hemorrhagic shock and encephalopathy syndrome – the markers for an early HSES diagnosis |
| title_short | Hemorrhagic shock and encephalopathy syndrome – the markers for an early HSES diagnosis |
| title_sort | hemorrhagic shock and encephalopathy syndrome the markers for an early hses diagnosis |
| url | http://www.biomedcentral.com/1471-2431/8/43 |
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