{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T19:54:35Z","timestamp":1791921275154,"version":"4.3.4"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T00:00:00Z","timestamp":1571616000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T00:00:00Z","timestamp":1571616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"New Advanced Technology Project at the Shanghai City Hospital Development Center","award":["SHDC12014116"],"award-info":[{"award-number":["SHDC12014116"]}]},{"DOI":"10.13039\/501100003399","name":"Science and Technology Commission of Shanghai Municipality","doi-asserted-by":"publisher","award":["17411968900"],"award-info":[{"award-number":["17411968900"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003399","name":"Science and Technology Commission of Shanghai Municipality","doi-asserted-by":"publisher","award":["16411970300"],"award-info":[{"award-number":["16411970300"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]},{"name":"the Multicenter Clinical Research Program of Shanghai Jiao Tong University School of Medicine","award":["DLY201618"],"award-info":[{"award-number":["DLY201618"]}]},{"name":"Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant support","award":["20171928"],"award-info":[{"award-number":["20171928"]}]},{"name":"Talents Program of Shanghai Jiao Tong University School of Medicine","award":["17XJ11018"],"award-info":[{"award-number":["17XJ11018"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n              <jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Hand, foot and mouth disease (HFMD) remains a burdensome health issue in mainland China. Enterovirus71 (EV-A71) is the main pathogen of severe HFMD. Continuous hemofiltration improves fluid overload, restores kidney function and alleviates inflammatory reactions. The aim of the present study was to evaluate the effects of continuous veno-venous hemodiafiltration (CVVHDF) on severe HFMD caused by EV-A71(EV-A71-HFMD) in a pediatric intensive care unit (PICU).<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A retrospective observational study was performed in a tertiary university PICU from January 2012 to December 2016. Children with severe EV-A71-HFMD complicated by cardiopulmonary failure were included. The patients were divided into a CVVHDF group and a conventional therapy (control) group (non-CVVHDF). The demographics, characteristics, and outcomes between the groups were collected and analyzed.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Twenty-nine patients with severe EV-A71-HFMD were enrolled. The 28-day mortality was 17.6% (3\/17) in the CVVHDF group and 33.3% (4\/12) in the non-CVVHDF group, with no statistical significance between the two groups (<jats:italic>P<\/jats:italic>\u2009=\u20090.403). The median interval between CVVHDF initiation and PICU admission was 6 (4,8.5) hrs, and the median duration of CVVHDF was 48 (36, 64) hrs. The left ventricular ejection fraction (LVEF) and cardiac index (CI) in the CVVHDF group were improved after treatment. The plasma levels of catecholamines and renin-angiotensin-aldosterone system (RAAS) substances in the CVVHDF group were significantly decreased after treatment. The decreased catecholamines and RAAS substances included adrenalin (169.8 [145.5, 244.6] vs. 148.0 [109.0, 208.1] ng\/L, <jats:italic>P<\/jats:italic>\u2009=\u20090.033), dopamine (152.7 [97.0, 191.1] vs. 96.0 [68.0, 160.9] ng\/L, <jats:italic>P<\/jats:italic>\u2009=\u20090.026), angiotensin II (185.9 [125.2, 800.0] vs. 106.0 [90.8, 232.5] ng\/L, <jats:italic>P<\/jats:italic>\u2009=\u20090.047), aldosterone (165.7 [94.0, 353.3] vs. 103.3 [84.3, 144.3] ng\/L, <jats:italic>P<\/jats:italic>\u2009=\u20090.033), and renin (1.12 [0.74, 3.45] vs. 0.79 [0.52, 1.25] \u03bcg\/L\/h, <jats:italic>P<\/jats:italic>\u2009=\u20090.029),<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>CVVHDF reduced the levels of catecholamines and RAAS substances and improved cardiovascular function. Continuous hemodiafiltration may represent a potential therapy in patients with severe EV-A71-HFMD complicated with cardiopulmonary failure.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-019-4519-9","type":"journal-article","created":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T16:20:27Z","timestamp":1571674827000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Continuous hemodiafiltration as a rescue therapy for patients with cardiopulmonary failure caused by enterovirus-71: a retrospective observational study in a PICU"],"prefix":"10.1186","volume":"19","author":[{"given":"Chunxia","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qunfang","family":"Rong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4905-3600","authenticated-orcid":false,"given":"Yucai","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,10,21]]},"reference":[{"key":"4519_CR1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001975","volume":"13","author":"JT Wu","year":"2016","unstructured":"Wu JT, Jit M, Zheng Y, et al. 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All the data were obtained from the medical records of patients. All data generated or analyzed during this study are available from the corresponding author upon reasonable request.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests exist.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"866"}}