Enterovirus A71 (EV-A71) is one of the causative pathogens of hand, foot, and mouth disease (HFMD), which may cause severe neurological and cardiopulmonary complications in children. In this review, we discuss the pathogenesis, clinical manifestations, management strategy, and clinical outcomes of cardiopulmonary failure (CPF) in patients with EV-A71 infection. The pathogenesis of CPF involves both catecholamine-related cardiotoxicity following brainstem encephalitis and vasodilatory shock due to cytokine storm. Sympathetic hyperactivity, including tachycardia and hypertension, are the early clinical manifestations of cardiopulmonary involvement, which may progress to pulmonary edema/hemorrhage and/or CPF. The management strategy comprises multidisciplinary supportive treatment, including fluid management, positive pressure ventilation support, and use of milrinone, vasopressors, and inotropes. Some patients may require extracorporeal membrane oxygenation. Major neurological sequelae are almost inevitable once a child develops life-threatening illness. Long-term care of these children is an important medico-social issue.

中文翻译：

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小儿感染肠道病毒A71的儿童心肺功能衰竭

肠病毒A71（EV-A71）是手足口病（HFMD）的病原体之一，可能导致儿童严重的神经系统和心肺并发症。在这篇综述中，我们讨论了EV-A71感染患者的心肺衰竭（CPF）的发病机制，临床表现，管理策略和临床结果。CPF的发病机制涉及脑干脑炎后儿茶酚胺相关的心脏毒性和细胞因子风暴引起的血管舒张性休克。交感亢进，包括心动过速和高血压，是心肺受累的早期临床表现，可能发展为肺水肿/出血和/或CPF。管理策略包括多学科支持治疗，包括液体管理，正压通气支持，以及米力农，升压药和正性肌力药的使用。一些患者可能需要体外膜氧合。一旦孩子患上危及生命的疾病，几乎就不可避免地出现重大神经系统后遗症。这些孩子的长期照护是一个重要的医学社会问题。