The role of tracheotomy in children with severe hand foot and mouth disease / 中国小儿急救医学

ABSTRACT

Objective To investigate the role of tracheotomy in children with severe hand foot and mouth disease.Methods Eight children with severe hand foot and mouth disease collected from July 2009 to August 2011 in PICU were retrospectively reviewed.Clinical manifestation and laboratory data were analyzed and followed up.Results Eight patients were enterovirus 71 (EV71) positive.Hormones,intravenous immune globulin,mechanical ventilation and vasodilators had been administered in patients with cardiopulmonary failure.They had severe neurologic sequelae,requiring prolonged intubation.MRI imaging of 7 cases showed abnormal brainstem,pons and medulla oblongata,1 case showed swelling of brain tissue.A total of 8 patients underwent a tracheotomy in mean (25.63 ± 8.86) d.The older was 22 months,the younger was 8 months and the mean age was (13.13 ±4.22) months.Four cases died,the other survived.Two cases were successfully decannulation,the other two were still in the tracheotomy.Conclusion Tracheostomy play an active role in reducing airway resistance,clearing airway secretions,providing the opportunity for subsequent rehabilitation.Eight patients were followed up for three years,neurological sequelae could not be restored.Four cases repeatedly suffer from pneumonia,atelectasis,leading to a serious decline in quality of life.