Pediatric Hantavirus Pulmonary Syndrome Treatment & Management

Updated: Nov 26, 2014
  • Author: Vinod K Dhawan, MD, FACP, FRCPC, FIDSA; Chief Editor: Russell W Steele, MD  more...
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Treatment

Medical Care

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  • No specific treatment is available for Hantavirus pulmonary syndrome (HPS).Treatment of Hantavirus pulmonary syndrome remains supportive, requiring invasive hemodynamic monitoring with an arterial line and a pulmonary artery catheter and intensive support. [10] Prompt treatment is of critical importance. Treatment initiated after the onset of severe respiratory distress is less likely to favorably impact the outcome.
  • Mechanical ventilation may be necessary for survival during the period of severe respiratory insufficiency.
  • Excessive administration of fluids should be avoided despite the fact that patients may be hemoconcentrated and hypotensive. Overzealous fluid administration may aggravate respiratory insufficiency because of increased vascular leak of fluid into the lungs.
  • Early use of pressors is recommended to correct hypotension.
  • Extracorporeal membrane oxygenation may be considered for patients with refractory shock. In one report, almost two thirds of the patients with severe Hantavirus pulmonary syndrome, with predicted mortality of 100%, who were supported with extracorporeal circulation survived and completely recovered. [11] However, the validity of this treatment is not well established through controlled trials.
  • High-dose intravenous methylprednisolone for hantavirus cardiopulmonary syndrome in was studied a double-blind, randomized controlled clinical trial in Chile. [39] . Although methylprednisolone appears to be safe, it did not provide any significant clinical benefit to patients.
  • Treatment with intravenous ribavirin, a guanosine analogue, conferred no survival benefit in an open-label trial. Hyperimmune serum offers a promising future therapy because survival is correlated with higher neutralizing antibody titers at admission.
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Consultations

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  • Infectious diseases specialist
  • Pulmonary medicine specialist
  • Critical care specialist
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