Objective: Enterovirus usually causes mild and self-limited infections in children, however, enterovirus 71 (EV71) may cause severe disease or sudden death. Acute cardiopulmonary failure was the major cause of sudden death. We proposed that extracorporeal life support system (ECLS) can rescue children with late stage EV71 infection.
Methods: A total 13 children with late stage EV71 infection were received ECLS resuscitation during 2000-2008 in Taiwan. They were compared with 10 children receiving conventional treatment (CT) during 1998-2000.
Results: There was no significant differences in demographic data and clinical manifestations, except their outcomes (p=0.024), between CT and ECLS group. The mortality rates of critical EV71 infection were 21.2% and 2.3% in CT and ECLS group, respectively. Among the 13 children rescued by ECLS, ten (77%) patients could successfully wean from ECLS and 3 patients died during ECLS. Total implantation time ranged from 38 to 145 hours (93 ± 33 hours) and weaning process was made of over 6 to 48 hours (27 ± 12 hours). Total duration of PICU admission and total hospitalization ranged from 3 to 162 days (47 ± 44 days) and 3 to 394 days (92 ± 114 days). Complications occurred in all patients including major complications in 4 (31%) patients and minor in 9 (69%).
Conclusions: Children with late stage EV71 infection receiving ECLS had higher survival rate and less neurologic sequelae than CT in this study. We suggested that ECLS should be considered for intensive cardiac resuscitation in children with late stage EV71 infection.