Volume 5, Issue 4, December 2019, Page: 183-186
The Rapeutic Effect of Milrinone Combined With Labetalol in Treatment of Severe Cardiopulmonary Failure Caused by Hand, Foot and Mouth Disese
Wenli Li, Department of Pediatrics, The Maternal and Child Health Hospital of Yichun, Yichun, China
Huiyuan Cheng, Department of Pediatrics, The People’s Hospital of Yichun, Yichun, China
Yuliang Cheng, Department of Pediatrics, The Maternal and Child Health Hospital of Yichun, Yichun, China
Received: Feb. 18, 2019;       Accepted: Jul. 25, 2019;       Published: Sep. 18, 2019
DOI: 10.11648/j.ajp.20190504.12      View  41      Downloads  16
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, X2=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.
Keywords
Milrinone, Labetalol, Severe Hand-Foot-Mouth Disease, Cardio-Pulmonary Failure
To cite this article
Wenli Li, Huiyuan Cheng, Yuliang Cheng, The Rapeutic Effect of Milrinone Combined With Labetalol in Treatment of Severe Cardiopulmonary Failure Caused by Hand, Foot and Mouth Disese, American Journal of Pediatrics. Vol. 5, No. 4, 2019, pp. 183-186. doi: 10.11648/j.ajp.20190504.12
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Hui Yu, early identification of severe case of pedetrician HFMD, China pediatrician magazine 2012, 4: 284-285.
[2]
Zhu J, Chen N, Zhou S, Severity of enterovirus A 71 infection in a human SCARB2 knock-in mouse model is dependent on infectious strain and route. Emerging microbes & infections 2018 Dec; 7 (1); 205.
[3]
Li XW Qian SY Wang Q Chinese guidelines for the diagnosis and treatment of hand, foot and mouth disease (2018 edition). World journal of pediatrics; WJP 2018 Oct; 14 (5); 437-447.
[4]
Mirand A Peigue-Lafeuille H Clinical characteristics and course of hand, foot, and mouth disease Archives de pediatrie; organe officiel de la Societe francaise de pediatrie 2017 Oct; 24 (10); 1036-1046.
[5]
Nanayakkara S Mak V Crannitch K Extended Release Oral Milrinone, CRD-102, for Advanced Heart Failure. The American journal of cardiology 2018 Sep; 122 (6); 1017-1020.
[6]
Chang YK, Chen KH, Chen KT Hand, foot and mouth disease and herpangina caused by enterovirus A 71 infections: a review of enterovirus A 71 molecular epidemiology, pathogenesis, and current vaccine development. Revista do Instituto de Medicina Tropical de Sao Paulo 2018 Nov; 60-70.
[7]
Nhan LNT Hong NTT Nhu LNT Severe enterovirus A 71 associated hand, foot and mouth disease, Vietnam, 2018: preliminary report of an impending outbreak. Euro surveillance; bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 2018 Nov; 23 (46).
[8]
Jones E Jones E Jones E Outcomes following severe hand foot and mouth disease: A systematic review and meta-analysis. Forensic science international. Genetics 2018 09; 36176-185.
[9]
Pan YZ Song CL Guo YJ Effects of L-carnitine on serum levels of brain natriuretic peptide and N-terminal pro-brain natriuretic peptide and cardiac function in children with severe hand-foot-mouth disease. Zhongguo Dang Dai Er Ke Za Zhi 2018 Aug; 20 (8); 635-640.
[10]
Sun JF Li HL Sun BX Correction to: Correlation analysis on serum inflammatory cytokine level and neurogenic pulmonary edema for children with severe hand-foot-mouth disease. European journal of medical research 2018 Jun; 23 (1); 33.
[11]
Liang RX Shi XY Zhang YH Etiology and clinical analysis of central nervous system infection caused by Coxsackievirus B 5 in severe hand, foot and mouth disease in Qingdao City, 2013-2014. Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine] 2018 Nov; 52 (11); 1168-1172.
[12]
Mirand A Peigue-Lafeuille H Clinical characteristics and course of hand, foot, and mouth disease Archives de pediatrie; organe officiel de la Societe francaise de pediatrie 2017 Oct; 24 (10); 1036-1046.
[13]
Lomis N Gaudreault F Malhotra M Novel Milrinone Nanoformulation for Use in Cardiovascular Diseases: Preparation and in Vitro Characterization. Molecular pharmaceutics 2018 Jul; 15 (7); 2489-2502.
[14]
Patel P Koli D Maitra N Comparison of Efficacy and Safety of Intravenous Labetalol Versus Hydralazine for Management of Severe Hypertension in Pregnancy. Journal of obstetrics and gynaecology of India 2018 Oct; 68 (5); 376-381.
[15]
Li XW Qian SY Wang Q Chinese guidelines for the diagnosis and treatment of hand, foot and mouth disease (2018 edition). World journal of pediatrics; WJP 2018 Oct; 14 (5); 437-447.
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