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Published in: Journal of Medical Case Reports 1/2012

Open Access 01-12-2012 | Case report

Continuous veno-venous hemofiltration for treatment of enterovirus 71-induced fulminant cardiopulmonary failure: a case report

Authors: Phuc Huu Phan, Hung Viet Dau, Son Thanh Chu, Thuy Bich Phung, Thang Van Pham, Tu Van Nguyen, Liem Thanh Nguyen

Published in: Journal of Medical Case Reports | Issue 1/2012

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Abstract

Introduction

Fulminant cardiopulmonary failure is a severe complication of hand, foot and mouth diseases due to enterovirus 71 infection, with a high mortality rate. The treatment is mainly supportive with aggressive cardiopulmonary resuscitation. We report the use of continuous veno-venous hemofiltration in a patient with pulmonary edema and shock due to enterovirus 71 infection. To the best of our knowledge, this is the first report of the use of continuous veno-venous hemofiltration to successfully treat a patient with fulminant cardiopulmonary failure due to enterovirus 71 infection.

Case presentation

A 36-month-old Asian girl presented to our hospital with pulmonary edema, refractory hypotension and severe cardiac dysfunction due to enterovirus 71 infection. In addition to the standard management and care, we performed continuous veno-venous hemofiltration to overcome refractory shock and our patient eventually made a full recovery. At a three-month follow-up, a full assessment revealed no neurological sequelae.

Conclusions

In the management of patients with enterovirus 71-related fulminant cardiopulmonary failure, early continuous veno-venous hemofiltration may be considered as an alternative treatment to improve patient survival and to prevent severe neurological disabilities.
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Literature
2.
go back to reference Chang LY, Lin TY, Hsu KH, Huang YC, Lin KL, Hsueh C, Shih SR, Ning HC, Hwang MS, Wang HS, Lee CY: Clinical features and risk factors of pulmonary oedema after enterovirus-71-related hand, foot, and mouth disease. Lancet. 1999, 354: 1682-1686. 10.1016/S0140-6736(99)04434-7.CrossRefPubMed Chang LY, Lin TY, Hsu KH, Huang YC, Lin KL, Hsueh C, Shih SR, Ning HC, Hwang MS, Wang HS, Lee CY: Clinical features and risk factors of pulmonary oedema after enterovirus-71-related hand, foot, and mouth disease. Lancet. 1999, 354: 1682-1686. 10.1016/S0140-6736(99)04434-7.CrossRefPubMed
3.
go back to reference Wang SM, Lei HY, Huang KJ, Wu JM, Wang JR, Yu CK, Su IJ, Liu CC: Pathogenesis of enterovirus 71 brainstem encephalitis in pediatric patients: roles of cytokines and cellular immune activation in patients with pulmonary edema. J Infect Dis. 2003, 188: 564-570. 10.1086/376998.CrossRefPubMed Wang SM, Lei HY, Huang KJ, Wu JM, Wang JR, Yu CK, Su IJ, Liu CC: Pathogenesis of enterovirus 71 brainstem encephalitis in pediatric patients: roles of cytokines and cellular immune activation in patients with pulmonary edema. J Infect Dis. 2003, 188: 564-570. 10.1086/376998.CrossRefPubMed
4.
go back to reference Wang SM, Lei HY, Yu CK, Wang JR, Su IJ, Liu CC: Acute chemokine response in the blood and cerebrospinal fluid of children with enterovirus 71-associated brainstem encephalitis. J Infect Dis. 2008, 198: 1002-1006. 10.1086/591462.CrossRefPubMed Wang SM, Lei HY, Yu CK, Wang JR, Su IJ, Liu CC: Acute chemokine response in the blood and cerebrospinal fluid of children with enterovirus 71-associated brainstem encephalitis. J Infect Dis. 2008, 198: 1002-1006. 10.1086/591462.CrossRefPubMed
5.
go back to reference Jan SL, Lin SJ, Fu YC, Chi CS, Wang CC, Wei HJ, Chang Y, Hwang B, Chen PY, Huang FL, Lin MC: Extracorporeal life support for treatment of children with enterovirus 71 infection-related cardiopulmonary failure. Intensive Care Med. 2010, 36: 520-527. 10.1007/s00134-009-1739-2.CrossRefPubMed Jan SL, Lin SJ, Fu YC, Chi CS, Wang CC, Wei HJ, Chang Y, Hwang B, Chen PY, Huang FL, Lin MC: Extracorporeal life support for treatment of children with enterovirus 71 infection-related cardiopulmonary failure. Intensive Care Med. 2010, 36: 520-527. 10.1007/s00134-009-1739-2.CrossRefPubMed
6.
go back to reference Goldstein SL, Somers JM, Baum MA, Symons JM, Brophy PD, Blowey D, Bunchman TE, Baker C, Mottes T, McAfee N, Barnett J, Morrison G, Rogers K, Fortenberry JD: Pediatric patients with multi-organ dysfunction syndrome receiving continuous renal replacement therapy. Kid International. 2007, 67: 653-658.CrossRef Goldstein SL, Somers JM, Baum MA, Symons JM, Brophy PD, Blowey D, Bunchman TE, Baker C, Mottes T, McAfee N, Barnett J, Morrison G, Rogers K, Fortenberry JD: Pediatric patients with multi-organ dysfunction syndrome receiving continuous renal replacement therapy. Kid International. 2007, 67: 653-658.CrossRef
7.
go back to reference Heering P, Morgera S, Schmitz FJ, Schmitz G, Willers R, Schultheiss HP, Strauer EB, Grabensee B: Cytokine removal and cardiovascular hemodynamics in septic patients with continuous veno-venous hemofiltration. Intensive Care Med. 1997, 23: 288-296. 10.1007/s001340050330.CrossRefPubMed Heering P, Morgera S, Schmitz FJ, Schmitz G, Willers R, Schultheiss HP, Strauer EB, Grabensee B: Cytokine removal and cardiovascular hemodynamics in septic patients with continuous veno-venous hemofiltration. Intensive Care Med. 1997, 23: 288-296. 10.1007/s001340050330.CrossRefPubMed
8.
go back to reference Peng Z, Pai P, Bao LH, Rong L, Min WH, Chen H: The impacts of continuous veno-venous hemofiltration on plasma cytokines and monocyte human leukocyte antigenDR expression in septic patients. Cytokine. 2010, 50: 186-191. 10.1016/j.cyto.2010.02.005.CrossRefPubMed Peng Z, Pai P, Bao LH, Rong L, Min WH, Chen H: The impacts of continuous veno-venous hemofiltration on plasma cytokines and monocyte human leukocyte antigenDR expression in septic patients. Cytokine. 2010, 50: 186-191. 10.1016/j.cyto.2010.02.005.CrossRefPubMed
9.
go back to reference Perera D, Podin Y, Akin W, Tan CS, Cardosa MJ: Incorrect identification of recent Asian strains of Coxsackievirus A16 as human enterovirus 71: improved primers for the specific detection of human enterovirus 71 by RT PCR. BMC Infect Dis. 2004, 4: 11-10.1186/1471-2334-4-11.CrossRefPubMedPubMedCentral Perera D, Podin Y, Akin W, Tan CS, Cardosa MJ: Incorrect identification of recent Asian strains of Coxsackievirus A16 as human enterovirus 71: improved primers for the specific detection of human enterovirus 71 by RT PCR. BMC Infect Dis. 2004, 4: 11-10.1186/1471-2334-4-11.CrossRefPubMedPubMedCentral
10.
go back to reference Solomon T, Lewthwaite P, Perera D, Cardosa MJ, McMinn P, Ooi MH: Virology epidemiology, pathogenesis, and control of enterovirus 71. Lancet Infect Dis. 2010, 10: 778-790. 10.1016/S1473-3099(10)70194-8.CrossRefPubMed Solomon T, Lewthwaite P, Perera D, Cardosa MJ, McMinn P, Ooi MH: Virology epidemiology, pathogenesis, and control of enterovirus 71. Lancet Infect Dis. 2010, 10: 778-790. 10.1016/S1473-3099(10)70194-8.CrossRefPubMed
11.
go back to reference Bellomo R, McGrath B, Boyce N: In vivo catecholamine extraction during continuous hemodiafiltration in inotrope-dependent patients [abstract]. ASAIO Trans. 1991, 37: M324-M325.PubMed Bellomo R, McGrath B, Boyce N: In vivo catecholamine extraction during continuous hemodiafiltration in inotrope-dependent patients [abstract]. ASAIO Trans. 1991, 37: M324-M325.PubMed
12.
go back to reference Bellomo R, McGrath B, Boyce N: Effect of continuous veno-venous hemofiltration with dialysis on hormone and catecholamine clearance in critically ill patients with acute renal failure [abstract]. Crit Care Med. 1994, 22: 833-837. 10.1097/00003246-199405000-00020.CrossRefPubMed Bellomo R, McGrath B, Boyce N: Effect of continuous veno-venous hemofiltration with dialysis on hormone and catecholamine clearance in critically ill patients with acute renal failure [abstract]. Crit Care Med. 1994, 22: 833-837. 10.1097/00003246-199405000-00020.CrossRefPubMed
Metadata
Title
Continuous veno-venous hemofiltration for treatment of enterovirus 71-induced fulminant cardiopulmonary failure: a case report
Authors
Phuc Huu Phan
Hung Viet Dau
Son Thanh Chu
Thuy Bich Phung
Thang Van Pham
Tu Van Nguyen
Liem Thanh Nguyen
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2012
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/1752-1947-6-159

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