[Risk factors of heart and lung failure in children with severe hand, foot and mouth disease and treatment experience].
OBJECTIVE
To study risk factors for severe hand, foot and mouth disease (HFMD) complicated by heart and lung failure and treatment experience.


METHODS
A total of 198 children with severe HFMD between March and August in 2011 were enrolled. Univariate analysis and logistic regression model were used to analyze the risk factors severe HFMD complicated by heart and lung failure. The effects of combination therapy with immunoglobulin+dexamethasone+ribavirin were observed.


RESULTS
Univariate analysis indicated that HFMD patients with heart and lung failure had higher proportions of consciousness, tachypnoea, abnormal hemodynamics, increased troponin and EV71 infection than HFMD patients without heart and lung failure (P<0.05).Multivariate logistic regression analysis indicated that tachypnoea, abnormal hemodynamics and EV71 infection were the main risk factors for heart and lung failure. Compared with combination therapy with dexamethasone+ribavirin, combination therapy with immunoglobulin+dexamethasone+ribavirin was more effective for preventing hemodynamic changes in children with severe HFMD (P<0.01). Compared with HFMD patients with heart and lung failure, the effect of the combination therapy with immunoglobulin+dexamethasone+ribavirin was better in HFMD patients without heart and lung failure (P<0.01).


CONCLUSIONS
The main risk factors for heart and lung failure in children with severe HFMD include tachypnoea, abnormal hemodynamics and EV71 infection. Early combination therapy with immunoglobulin+dexamethasone+ribavirin can reduce the incidence of heart and lung failure in children with severe HFMD.
Department of Emergency, West China the Second Hospital of Sichuan University, Chengdu 610041, China.
Zhong-Qiang
ZQ
Liu
Xi-Hong
XH
Li
Hui-Qing
HQ
Wang
Yue
Y
Luo
De-Zhi
DZ
Mu
D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005260:Female; D006232:Hand, Foot and Mouth Disease / Q000150:complications*; D006333:Heart Failure / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D012131:Respiratory Insufficiency / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors