Hiệu quả của lọc máu liên tục tính mạch - tĩnh mạch (CVVH) trong điều trị bệnh tay chân miệng có biến chứng suy tuần hoàn và suy hô hấp cấp tại khoa hồi sức cấp cứu

The aim study is to determine the role of continuous veno-venous (CVVH) in treatment for hand, foot and mouth disease (HFMD) with fulminant cardiopulmonary failure. The results indicated that from 9/2011 to 5/2012 there were 32 patients with fulminant cardiopulmonary failure caused by HFMD, who admitted in the PICU, National Hospital of Pediatrics.The average age was 23.7 + or - 16.7 months. The average duration of critical life threatening signs and symptoms was 3.1 days (2 4 days). Before admission in PICU there were 18 patients (34.4 percent), who was not diagnosed HFMD. The mean number of used inotropes was 2.9 + or - 0.7. The percentage of positive EV cases was 40.6 percent and positive EV71 cases was 15.6 percent. At 6 hours after initiating CVVH: temperature, heart rate, systonic blood pressure normallized. At 12 hours after CVVH started: WBC, neutrophils and lactate decreased; elevated EF and blood HCO3-; reducing of dose of Dobutamine, Adrenaline, Nor-adrenaline. IFN-g, IL-6; IL-6r, IL-8, IL-12p40, TNF-r2, MCP-1 were detected in ultrafitrate fluid, but only IL-6 decreased in blood at 24 after CVVH starting. 68,8 percent patients were survival without any sequelae, survival with neurological sequelae was 15.6 percent and the mortarity rate was 15.6 percent. Conclusions: CVVH can remove TFN-g, IL-6; IL-6r, IL-8, IL-12p40, TNF-r2, MCP-1 from the ciculation and reduced IL-6 level in blood HFMD patients. Cardiovascular hemodynamics, metabolic to improve after induction of CVVH in HFMD with fulminant cardiopulmonary failure.