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汉坦病毒心肺综合征:公共卫生关注点。

Hantavirus induced cardiopulmonary syndrome: A public health concern.

机构信息

Saint Joseph's Hospital Medical Center, Phoenix, Arizona.

Applied BioCode, Santa Fe Springs, Calofornia.

出版信息

J Med Virol. 2018 Jun;90(6):1003-1009. doi: 10.1002/jmv.25054. Epub 2018 Mar 15.

Abstract

Hantavirus cardiopulmonary syndrome is characterized by pulmonary capillary leakage and alveolar flooding, resulting in 50% mortality due to fulminant hypoxic respiratory failure. In addition, depression of cardiac function ensues, which complicates the picture with cardiogenic shock. Early diagnosis and appropriate use of extracorporeal membrane oxygenation (ECMO) are amongst the lifesaving interventions in this fatal illness. However, a recent case report demonstrates that implementation of high volume continuous hemofilteration along with protective ventilation reverses the cardiogenic shock within few hours in hantavirus infected patients. This review article is focused on the recent advances in clinical features, diagnosis, management, epidemiology, and pathogenesis of hantavirus induced cardiopulmonary syndrome. It provides information for clinicians to help in correct diagnosis during the early stages of viral infection that could improve the prognosis of this viral illness.

摘要

汉坦病毒心肺综合征的特征是肺毛细血管渗漏和肺泡积水,导致 50%的患者因暴发性低氧性呼吸衰竭而死亡。此外,还会出现心脏功能抑制,使心源性休克的情况更加复杂。在这种致命疾病中,早期诊断和适当使用体外膜氧合 (ECMO) 是挽救生命的干预措施之一。然而,最近的一份病例报告表明,在汉坦病毒感染患者中,实施高容量持续血液滤过和保护性通气可以在数小时内逆转心源性休克。本文综述了汉坦病毒引起的心肺综合征的临床特征、诊断、治疗、流行病学和发病机制的最新进展。为临床医生提供了在病毒感染早期帮助正确诊断的信息,这可能会改善这种病毒性疾病的预后。

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