Abstract
Goal research on therapeutic effect of milrinone combined with Labetalol in treatment of severe cardiopulmonary failure induced by Hand, Foot and Mouth disease. Method: 50 cases of stage 3 pediatric patients with Hand, foot and Mouth disease between January 2010 – February 2014, randomly assigned to treatment group vs control group with 28 cases in each group. No statistical difference (p>0.05) was found between two groups in terms of patient age, sex and blood pressure, heart rate. Two groups were treated according to guideline on severe Hand, Foot and Mouth diseases, including supplemental oxygen, blood glucose monitoring, vital sign monitoring, anti-virus, methylprednisolone, lowering intracranial pressure, gama- globulin, milrinone (loading dose 50 ug/kg, slow infusion within 10 minutes, maintenance dose 0.25-0.75 ug/kg/min using micro-infusion pump). Besides above mentioned regular treatment, treatment group received labetalol (1-2 mg/kg/day, oral, q 8 h, Tid, hold when sinus rhythm lower than 20-30% of baseline, normal bp, heart rate between 120-130). Data on heart rate, bp variation, mechanical ventilation, adverse reaction after 24 hour, 48 hour and 72 hour was recorded by x±s and compared using t-test. RESULT: Blood pressure is 109±10.38 24 hours after treatment in treatment group. Heart rate is 132±15.64 beats/minutes. Blood pressure is 91±8.3 mmHg 48 hours after treatment. Heart rate is 122±17.8/minutes. Blood pressure is 89±11.4mmHg 72 hours after treatment. Heart rate is1 02±14.8 beats/minutes.. Blood pressure, heart rate has substantial improvement on treatment group compared with control group. The difference is statistically significant (p<0.05). Comparing mechanical ventilation rate between two group (mechanical ventilation case before initiation of treatment was not taken into account), treatment group only have 1 case (0.04%), whereas control group has 6 cases (24%). Difference between two group is statistically significant, X<i>2</i>=4.37, P<0.05. And no adverse reaction was found. Conclusion: Milrinone combined with Labetalol significantly improves cardio-pulmonary function in cardio -pulmonary failure patient caused by severe hand, foot, mouth disease. Combined treatment significantly prevent disease progression and improves prognosis.
Highlights
Hand-foot-mouth disease is a common contagious illness that was caused by enterovirus, transmitted by nasopharyngeal secretions such as saliva, by direct contact, or by fecal-oral transmission [1]
We found that heart rate was poorly controlled in majority cases that is on milrinone treatment
Since January 2012, Our center achieve significant therapeutic success in treatment of sever HFMD using Milrinone combined with labetalol
Summary
Hand-foot-mouth disease is a common contagious illness that was caused by enterovirus, transmitted by nasopharyngeal secretions such as saliva, by direct contact, or by fecal-oral transmission [1]. Most cases of HFMD diseases have minor clinical symptoms such as fever, rash on hand/foot/mouth/buttock, whereas small amount of cases can progress to cardio-pulmonary failure, damaging neuro system and even lead to death [2]. The specialist for HFMD in health department have published protocol for clinician (2011 version) to divide EV 71 into 5 stages and recommend milrinone for stage 3 cario-cardio-pulmonary failure [3]. We found that heart rate was poorly controlled in majority cases that is on milrinone treatment. It is noted that side effect of milrinone involves fast heart rate in the instructions [4,5].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
