title: [Characteristics of circulatory disturbance and the treatment of severe hand-foot-and-mouth disease].
abstract: OBJECTIVE
  To investigate the characteristics of circulatory disturbance and treatment of severe hand-foot-and-mouth disease (HFMD).
  
  
  METHODS
  The clinical characteristics, laboratory findings, therapy and outcome of 22 severe HFMD patients were retrospectively analyzed.
  
  
  RESULTS
  All the 22 severe HFMD patients came from the countryside. All these patients had encephalitis. Fifteen cases had myocardial injury. All had symptoms of sympathetic excitation and 17 cases had hypertension [(128 ± 16)/(81 ± 14) mm Hg (1 mm Hg = 0.133 kPa)]. Fourteen cases had exacerbation with rapid decline of blood pressure [(61 ± 12)/(33 ± 12) mm Hg]. In cardiorespiratory failure stage, 13 patients had neurogenic pulmonary edema accompanied by circulatory failure and 12 cases had a lower glasgow scores (less than 7). Myocardial injury and ECG change were found in some cases. Inotropic and pressor drugs were given in patients with circulatory collapse. Five cases received fluid resuscitation due to refractoriness to inotropic drugs. Nine patients received blood purification. Seventeen survived and 5 cases died due to circulatory failure.
  
  
  CONCLUSIONS
  Circulation failure of severe HFMD is the main cause of death. Early and appropriate circulation support is very important to reduce mortality.
authors.affiliation: Shengjing Hospital of China Medical University, Shenyang, China.
authors.forename: Xiao-yu
authors.initials: XY
authors.lastname: Xiong
authors.forename: Chun-feng
authors.initials: CF
authors.lastname: Liu
authors.forename: Li-jie
authors.initials: LJ
authors.lastname: Wang
authors.forename: Jiu-jun
authors.initials: JJ
authors.lastname: Li
authors.forename: Wei
authors.initials: W
authors.lastname: Xu
authors.forename: Guang-fu
authors.initials: GF
authors.lastname: Wen
authors.forename: Wen-liang
authors.initials: WL
authors.lastname: Song
authors.forename: Yu-jing
authors.initials: YJ
authors.lastname: Wang
mesh_terms: D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003131:Combined Modality Therapy; D005260:Female; D006232:Hand, Foot and Mouth Disease / Q000150:complications / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D020105:Milrinone / Q000008:administration & dosage* / Q000627:therapeutic use; D009102:Multiple Organ Failure / Q000209:etiology / Q000401:mortality*; D011654:Pulmonary Edema / Q000209:etiology / Q000401:mortality*; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012769:Shock / Q000209:etiology / Q000401:mortality; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous; D020105:Milrinone