{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T21:03:19Z","timestamp":1783976599437,"version":"3.55.0"},"reference-count":22,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2002,2,1]]},"abstract":"<jats:p>Background. The pathogenesis of acute pulmonary edema and cardiac collapse after enterovirus 71 (EV71) infection are not completely understood.<\/jats:p>\n               <jats:p>Objective. To determine the hemodynamic features and the mechanism of pulmonary edema (PE) after EV71 infection by direct intracardiac monitoring.<\/jats:p>\n               <jats:p>Design. Prospective clinical and laboratory study at a tertiary medical center.<\/jats:p>\n               <jats:p>Participants. Five consecutive infants, ages 2 to 13 months, with EV71 infection\u2014proved by viral isolation in 4 and antibody in 1\u2014with PE were enrolled. The clinical characteristics were systemically assessed. Hemodynamic profiles were determined every 4 hours by simultaneously implanted pulmonary arterial and central venous catheters during the acute stage.<\/jats:p>\n               <jats:p>Results. Magnetic resonance imaging revealed that all 5 infants had brainstem lesions. All patients had tachycardia and hyperthermia. Transient systolic hypertension was noted in 1 patient, and 1 presented with hypotension. Pulmonary artery pressure in all 5 infants was normal or mildly elevated (26\u201331 mm Hg), and central venous pressure ranged from 10 to 22 mm Hg. Pulmonary artery occlusion pressures were normal or slightly elevated (13\u201316 mm Hg). Systemic and pulmonary vascular resistances were transiently increased in only 1 patient. The stroke volume index decreased to 15.3 to 35.7 mL\/M2 (normal: 30\u201360 mL\/M2), but because of the elevated heart rate, the cardiac index did not decrease. All hemodynamics normalized within days.<\/jats:p>\n               <jats:p>Conclusion. Fulminant EV71 infection may lead to severe neurologic complications and acute PE. The acute PE and cardiopulmonary decompensation in EV71 infection are not directly caused by viral myocarditis. The mechanism of PE may be related to increased pulmonary vascular permeability caused by brainstem lesions and\/or systemic inflammatory response instead of increased pulmonary capillary hydrostatic pressure.<\/jats:p>","DOI":"10.1542\/peds.109.2.e26","type":"journal-article","created":{"date-parts":[[2004,8,14]],"date-time":"2004-08-14T00:17:55Z","timestamp":1092442675000},"page":"e26-e26","source":"Crossref","is-referenced-by-count":61,"title":["Cardiopulmonary Manifestations of Fulminant Enterovirus 71 Infection"],"prefix":"10.1542","volume":"109","author":[{"given":"Jing-Ming","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jieh-Neng","family":"Wang","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Chien","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-Chuan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao-Ching","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yung-Jung","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsu-Fuh","family":"Yeh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2002,2,1]]},"reference":[{"key":"2021121006174841000_R1","doi-asserted-by":"crossref","unstructured":"Wang SM, Liu CC, Tseng HW, et al. 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