This protocol covers hand-foot-and-mouth disease (HFMD) that has progressed to its most critical and severe stage: established cardiopulmonary failure in the setting of autonomic nervous system (ANS) dysregulation.
Clinical scenario: Children with HFMD at this stage present with ANS dysregulation accompanied by one or more of: hypotension or shock, pulmonary oedema, pulmonary haemorrhage, or heart failure. This represents the last and most severe stage of the disease and carries a very poor prognosis.
Treatment approach (partial): For children reaching this critical threshold, management at selected centres may involve an advanced extracorporeal mechanical support technique employed as a rescue intervention — the complete protocol, indications, and clinical decision sequence are available via the link below.