The fluid management and hemodynamic characteristics of PiCCO employed on young children with severe hand, foot, and mouth disease—a retrospective study
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 circula...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-02-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-021-05889-z |
| _version_ | 1819163886491795456 |
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| author | Fengyun Wang Xinhua Qiang Suhua Jiang Jingsong Shao Bin Fang Lixin Zhou |
| author_facet | Fengyun Wang Xinhua Qiang Suhua Jiang Jingsong Shao Bin Fang Lixin Zhou |
| author_sort | Fengyun Wang |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-22T17:51:15Z |
| format | Article |
| id | doaj.art-e1a5c873de7f4ac2b842e14fb8e9782e |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-22T17:51:15Z |
| publishDate | 2021-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-e1a5c873de7f4ac2b842e14fb8e9782e2022-12-21T18:18:11ZengBMCBMC Infectious Diseases1471-23342021-02-012111710.1186/s12879-021-05889-zThe fluid management and hemodynamic characteristics of PiCCO employed on young children with severe hand, foot, and mouth disease—a retrospective studyFengyun Wang0Xinhua Qiang1Suhua Jiang2Jingsong Shao3Bin Fang4Lixin Zhou5Department of Critical Care Medicine, The First People’s Hospital of FoshanDepartment of Critical Care Medicine, The First People’s Hospital of FoshanDepartment of Pediatric Intensive Care Units, The First People’s Hospital of FoshanDepartment of Critical Care Medicine, The First People’s Hospital of FoshanDepartment of Critical Care Medicine, The First People’s Hospital of FoshanDepartment of Critical Care Medicine, The First People’s Hospital of FoshanAbstract 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.https://doi.org/10.1186/s12879-021-05889-zHand, foot, and mouth diseaseEnterovirus 71Pulse indicator continuous cardiac outputAcute pulmonary edemaFluid management |
| spellingShingle | Fengyun Wang Xinhua Qiang Suhua Jiang Jingsong Shao Bin Fang Lixin Zhou The fluid management and hemodynamic characteristics of PiCCO employed on young children with severe hand, foot, and mouth disease—a retrospective study BMC Infectious Diseases Hand, foot, and mouth disease Enterovirus 71 Pulse indicator continuous cardiac output Acute pulmonary edema Fluid management |
| title | The fluid management and hemodynamic characteristics of PiCCO employed on young children with severe hand, foot, and mouth disease—a retrospective study |
| title_full | The fluid management and hemodynamic characteristics of PiCCO employed on young children with severe hand, foot, and mouth disease—a retrospective study |
| title_fullStr | The fluid management and hemodynamic characteristics of PiCCO employed on young children with severe hand, foot, and mouth disease—a retrospective study |
| title_full_unstemmed | The fluid management and hemodynamic characteristics of PiCCO employed on young children with severe hand, foot, and mouth disease—a retrospective study |
| title_short | The fluid management and hemodynamic characteristics of PiCCO employed on young children with severe hand, foot, and mouth disease—a retrospective study |
| title_sort | fluid management and hemodynamic characteristics of picco employed on young children with severe hand foot and mouth disease a retrospective study |
| topic | Hand, foot, and mouth disease Enterovirus 71 Pulse indicator continuous cardiac output Acute pulmonary edema Fluid management |
| url | https://doi.org/10.1186/s12879-021-05889-z |
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