[Clinical characteristics and prognostic factors of children with critical hand-foot-mouth disease treated with mechanical ventilation].

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 signifi cantly lower mean age(8±3 months vs 25±18 months; P0.05). Poor peripheral circulation above the elbow or knee joint, pulmonary edema involving at least two thirds of the lung fi eld, and pulmonary hemorrhage were all closely related to death(P0.01). The death cases and cured cases had signifi cantly different peripheral white blood cell counts, blood lactic acid, and blood glucose(24±11×109/L vs 12±5×109/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 90 had a signifi cantly higher death risk(P0.01). Conclusions 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 fi eld, and pulmonary hemorrhage. Signifi cant 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.