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01-03-2010 | Pediatric Original

Extracorporeal life support for treatment of children with enterovirus 71 infection-related cardiopulmonary failure

Authors: Sheng-Ling Jan, Shing-Jong Lin, Yun-Ching Fu, Ching-Shiang Chi, Chung-Chi Wang, Hao-Ji Wei, Yen Chang, Betau Hwang, Po-Yen Chen, Fang-Liang Huang, Ming-Chih Lin

Published in: Intensive Care Medicine | Issue 3/2010

Abstract

Purpose

Enterovirus 71 (EV71) infection leading to cardiopulmonary failure (CPF) is rare, but usually fatal. In such cases, intensive cardiorespiratory support is essential for survival. In this study, we report our experience in the treatment of EV71-related CPF with extracorporeal life support (ECLS).

Methods

This was a retrospective study of a total of 13 children, aged 16 ± 10 months, with EV71-related hemodynamically unstable CPF, which was refractory to conventional treatments, who were rescued by transsternal ECLS from 2000 to 2008. The clinical manifestations and outcomes of the 13 children (present cohort) were compared with those of 10 children (past cohort) who had EV71-related CPF without ECLS between 1998 and 2000.

Results

Among these 13 patients, 10 were successfully weaned off ECLS and survived. The myocardial recovery time was 71 ± 28 (median, 69) h, and the ECLS duration was 93 ± 33 (median, 93) h. Six surviving patients had a good neurological outcome at hospital discharge. All surviving patients had some neurological sequelae but showed improvement at follow-up, including dysphagia in nine, central hypoventilation in seven, limb weakness in six and seizure in three. The present cohort had better neurological outcomes (46 vs. 0%, P = 0.005) and a higher survival rate (77 vs. 30%, P = 0.024) than the past cohort, respectively.

Conclusions

Patients with EV71-related CPF supported by ECLS had a higher survival rate and fewer neurological sequelae than those who only received conventional treatments. ECLS is an effective alternative method for treatment of children with refractory EV71-related CPF.

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Title: Extracorporeal life support for treatment of children with enterovirus 71 infection-related cardiopulmonary failure
Authors: Sheng-Ling Jan
Shing-Jong Lin
Yun-Ching Fu
Ching-Shiang Chi
Chung-Chi Wang
Hao-Ji Wei
Yen Chang
Betau Hwang
Po-Yen Chen
Fang-Liang Huang
Ming-Chih Lin
Publication date: 01-03-2010
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 3/2010
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-009-1739-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Extracorporeal life support for treatment of children with enterovirus 71 infection-related cardiopulmonary failure

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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