Đặc điểm lâm sàng và cận lâm sàng của bệnh tay chân miệng có biến chứng suy tuần hoàn và suy hô hấp cấp điều trị tại khoa hồi sức cấp cứu

The aim study is to determine the clinical features of hand, foot and mouth disease (HFMD) with fulminant cardiopulmonary failure. The results indicated that from 9/2011-5/2012 there were 32 patients with fulminant cardiopulmonary failure caused by HFMD who admitted in the PICU, National Hospital of Pediatrics. Male was 50.5 percent and female was 43.4 percent. The average age wass 23.7 + or - 16.7 months. The average duration of critical life threatening signs and symptoms was 3.1 days (2-4 days). 40.6 percent of patient were not supported bag ventilation before admission in PICU and 18 patients (34.4 percent) were not diagnosed HFMD. The severe clinical signs were: fever or = 39.5oC (40.6 percent), tarchycardia, bloody sputum (40.6 percent), meningoencephalitis (28.1 percent), MODS (100 percent), main organ failure were: cardiology failure (100 percent), respiratory failure (100 percent), neurology failure (93.8 percent). The mean number of used inotropes was 2.9 + or - 0.7. Laboratory examination showed: leucocytosis, elavated serum lactate, glucose, CK-MB, Troponin T and proBNP. PT 70 percent (65.6 percent). Bilateral pulmonary infiltrates without cardiomegaly on chest X-ray, reduced cardiac contractility on echocardiography. 9/11 patients (72.8 percent) had injured brain on MRI. The mortarity rate was 15.6 percent and neurological sequelae was 15.6 percent. Conclusions: HFMD with complication fulminant cardiopulmonary failure had high mortality and sequelae-rate, so that they should be close mornitoring.