title: [Clinical application of cardiac output monitoring in children with severe hand-foot-mouth disease].
abstract: OBJECTIVE
  Significant cardiac dysfunction has been found in children with severe hand-foot-mouth disease and heart failure is the major cause of death in these patients. Evaluation of cardiac function is essential for the treatment of severe cases. This study evaluated the clinical value of cardiac output monitoring in children with severe hand-foot-mouth disease.
  
  
  METHODS
  A total of 107 children with severe hand-foot-mouth disease admitted to the pediatric intensive care unit from April 2011 to September 2011 were enrolled and divided into three groups by clinical stage: 73 cases in stage 2, 23 cases in stage 3 and 11 cases in stage 4. Cardiac output and stroke volume were measured by ultrasonic cardiac output monitors (USCOM). Ninety-five children received MRI scanning and were grouped according to the results of MRI: 41 cases (medulla oblongata involvements in 9 cases) in abnormal MRI group and 54 cases in normal MRI group. Cardiac output was compared between the children in different clinical stages and between different MRI results.
  
  
  RESULTS
  Compared with children in clinical stages 2 and 3, cardiac output in children in clinical stage 4 decreased significantly (P<0.05). There was no differences in cardiac output between the normal and abnormal MRI groups, however cardiac output was significantly lower in children with medulla oblongata involvement than in those with other involvements and normal MRI.
  
  
  CONCLUSIONS
  Significant decrease in cardiac output suggests critical conditions and medulla oblongata cardiovascular center involvement in children with severe hand-foot-mouth disease. Dynamic measurement of cardiac output is valuable for treatment of the disease.
authors.affiliation: Shenzhen Children's Hospital, Shenzhen, Guangdong, China.
authors.forename: Hua-Bo
authors.initials: HB
authors.lastname: Cai
authors.forename: Ping
authors.initials: P
authors.lastname: Song
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.forename: Shi-Lei
authors.initials: SL
authors.lastname: Jia
authors.forename: Jin-Lan
authors.initials: JL
authors.lastname: Zhu
authors.forename: Wei-Guo
authors.initials: WG
authors.lastname: Yang
authors.forename: Yan-Xia
authors.initials: YX
authors.lastname: He
mesh_terms: D002302:Cardiac Output / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006232:Hand, Foot and Mouth Disease / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008991:Monitoring, Physiologic