Abstract：Objective To investigate the clinical characteristics of children with critical hand-foot-mouth disease (HFMD) who were treated with mechanical ventilation and to explore the risk factors for poor prognosis. Methods The clinical data of 63 children with critical HFMD who were admitted to the pediatric intensive care unit between April 2012 and September 2013 and needed mechanical ventilation were retrospectively analyzed. Results Among the 63 children, 43 were boys and 20 were girls, and their mean age was 25±18 months, with 81% under 3 years old. The four death cases were all under three years old. Compared with the cured cases, the death cases had a significantly lower mean age (8±3 months vs 25±18 months; PP9/L vs 12±5×10,9/L; 6.6±1.8 mmol/L vs 3.6±1.7 mmol/L; 16.4±2.5 mmol/L vs 10.0±3.0 mmol/L). The cases with critical illness score PConclusions Children with critical HFMD are mainly under 3 years old. The children face extremely high risk of death when they suffer from poor peripheral circulation above the elbow or knee joint, pulmonary edema involving at least two thirds of the lung field, and pulmonary hemorrhage. Significant increases in peripheral white blood cell counts, blood lactic acid, and blood glucose are risk factors for poor prognosis. Critical illness score is also related to poor prognosis.
LIU Rui-Hai,LI Jing,QU Xian-Feng et al. Clinical characteristics and prognostic factors of children with critical hand-footmouth disease treated with mechanical ventilation[J]. CJCP, 2015, 17(3): 249-253.
Nguyen NT, Pham HV, Hoang CQ, et al. Epidemiological and clinical characteristics of children who died from hand, foot and mouth disease in Vietnam, 2011[J]. BMC Infect Dis, 2014, 14(6): 341.
Bai Z, Zhu X, Li M, et al. Effectiveness of predicting in-hospital mortality in critically ill children by assessing blood lactate levels at admission[J]. BMC Pediatr, 2014, 14: 83.
Pan JH, Chen MW, Zhang XZ. High risk factors for severe hand, foot and mouth disease: A multicenter retrospective survey in Anhui Province China, 2008-2009[J]. Indian J Dermatol, 2012, 57(4): 316-321.
