Abstract
The outcome of children with the Acquired Immunodeficiency Syndrome(AIDS) with acute respiratory failure(ARF) requiring assisted ventilation(AV) was evaluated. All admissions <18 yrs who met CDC criteria for AIDS, were HTLV-III antibody positive, and received AV were analyzed. Two groups resulted: 1) AV for ARF and 2) AV for non-ARF (lung biopsy, bronchoaveolar lavage, shock, apnea). 20 PICU admissions met study criteria; 8 for ARF(40%) and 12 for non-ARF(60%). Mortality from ARF (7/8, 88%) was significantly higher than for non-ARF ( 3/12, 25%; p=0.02, Fishers 2-tailed). From lung biopsy or lavage in 17 patients, pneumocystis carinii (PCP) was the most frequently identified pathogen (11 of 17, 65%). The incidence of PCP did not differ significantly between ARF(3/8, 38%) and non-ARF patients (8/12, 67%) nor between survivors (5/10, 50%) and nonsurvivors (6/10, 60%). Children with AIDS who develop ARF requiring AV have a very poor prognosis compared to those receiving AV for other reasons. These results may be important to decisions regarding institution of AV in children with AIDS who develop ARF.
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Maio-Hunter, A., Notterman, D., Wilkinson, J. et al. ACQUIRED IMMUNODEFICIENCY SYNDROME IN CHILDREN: OUTCOME FOLLOWING ASSISTED VENTILATION. Pediatr Res 21 (Suppl 4), 201 (1987). https://doi.org/10.1203/00006450-198704010-00208
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DOI: https://doi.org/10.1203/00006450-198704010-00208