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Etiology and Outcome of Patients with HIV Infection and Respiratory Failure Admitted to the Intensive Care Unit

Background. Although access to HAART has prolonged survival and improved quality of life, HIV-infected patients with severe immunosuppression or comorbidities may develop complications that require critical care support. Our objective is to evaluate the etiology of respiratory failure in patients wi...

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Autores principales: Orsini, Jose, Ahmad, Noeen, Butala, Ashvin, Flores, Rosemarie, Tran, Truc, Llosa, Alfonso, Fishkin, Edward
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3771454/
https://www.ncbi.nlm.nih.gov/pubmed/24065988
http://dx.doi.org/10.1155/2013/732421
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author Orsini, Jose
Ahmad, Noeen
Butala, Ashvin
Flores, Rosemarie
Tran, Truc
Llosa, Alfonso
Fishkin, Edward
author_facet Orsini, Jose
Ahmad, Noeen
Butala, Ashvin
Flores, Rosemarie
Tran, Truc
Llosa, Alfonso
Fishkin, Edward
author_sort Orsini, Jose
collection PubMed
description Background. Although access to HAART has prolonged survival and improved quality of life, HIV-infected patients with severe immunosuppression or comorbidities may develop complications that require critical care support. Our objective is to evaluate the etiology of respiratory failure in patients with HIV infection admitted to the ICU, its relationship with the T-lymphocytes cell count as well as the use of HAART, and its impact on outcome. Methods. A single-center, prospective, and observational study among all patients with HIV-infection and respiratory failure admitted to the ICU from December 1, 2011, to February 28, 2013, was conducted. Results. A total of 42 patients were admitted during the study period. Their median CD(4) cell count was 123 cells/μL (mean 205.7, range 2.0–694.0), with a median HIV viral load of 203.5 copies/mL (mean 58,676, range <20–367,649). At the time of admission, 23 patients (54.8%) were receiving HAART. Use of antiretroviral therapy at ICU admission was not associated with survival, but it was associated with higher CD(4) cell counts and lower HIV viral loads. Twenty-five patients (59.5%) had respiratory failure secondary to non-HIV-related diseases. Mechanical ventilation was required in 36 patients (85.1%). Thirteen patients (31.0%) died. Conclusions. Noninfectious etiologies of respiratory failure account for majority of HIV-infected patients admitted to ICU. Increased mortality was observed among patients with sepsis as etiology of respiratory failure (HIV related and non-AIDS related), in those receiving mechanical ventilation, and in patients with decreased CD(4) cell count. Survival was not associated with the use of HAART. Complementary studies are warranted to address the impact of HAART on outcomes of HIV-infected patients with respiratory failure admitted to ICU.
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spelling pubmed-37714542013-09-24 Etiology and Outcome of Patients with HIV Infection and Respiratory Failure Admitted to the Intensive Care Unit Orsini, Jose Ahmad, Noeen Butala, Ashvin Flores, Rosemarie Tran, Truc Llosa, Alfonso Fishkin, Edward Interdiscip Perspect Infect Dis Clinical Study Background. Although access to HAART has prolonged survival and improved quality of life, HIV-infected patients with severe immunosuppression or comorbidities may develop complications that require critical care support. Our objective is to evaluate the etiology of respiratory failure in patients with HIV infection admitted to the ICU, its relationship with the T-lymphocytes cell count as well as the use of HAART, and its impact on outcome. Methods. A single-center, prospective, and observational study among all patients with HIV-infection and respiratory failure admitted to the ICU from December 1, 2011, to February 28, 2013, was conducted. Results. A total of 42 patients were admitted during the study period. Their median CD(4) cell count was 123 cells/μL (mean 205.7, range 2.0–694.0), with a median HIV viral load of 203.5 copies/mL (mean 58,676, range <20–367,649). At the time of admission, 23 patients (54.8%) were receiving HAART. Use of antiretroviral therapy at ICU admission was not associated with survival, but it was associated with higher CD(4) cell counts and lower HIV viral loads. Twenty-five patients (59.5%) had respiratory failure secondary to non-HIV-related diseases. Mechanical ventilation was required in 36 patients (85.1%). Thirteen patients (31.0%) died. Conclusions. Noninfectious etiologies of respiratory failure account for majority of HIV-infected patients admitted to ICU. Increased mortality was observed among patients with sepsis as etiology of respiratory failure (HIV related and non-AIDS related), in those receiving mechanical ventilation, and in patients with decreased CD(4) cell count. Survival was not associated with the use of HAART. Complementary studies are warranted to address the impact of HAART on outcomes of HIV-infected patients with respiratory failure admitted to ICU. Hindawi Publishing Corporation 2013 2013-08-28 /pmc/articles/PMC3771454/ /pubmed/24065988 http://dx.doi.org/10.1155/2013/732421 Text en Copyright © 2013 Jose Orsini et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Orsini, Jose
Ahmad, Noeen
Butala, Ashvin
Flores, Rosemarie
Tran, Truc
Llosa, Alfonso
Fishkin, Edward
Etiology and Outcome of Patients with HIV Infection and Respiratory Failure Admitted to the Intensive Care Unit
title Etiology and Outcome of Patients with HIV Infection and Respiratory Failure Admitted to the Intensive Care Unit
title_full Etiology and Outcome of Patients with HIV Infection and Respiratory Failure Admitted to the Intensive Care Unit
title_fullStr Etiology and Outcome of Patients with HIV Infection and Respiratory Failure Admitted to the Intensive Care Unit
title_full_unstemmed Etiology and Outcome of Patients with HIV Infection and Respiratory Failure Admitted to the Intensive Care Unit
title_short Etiology and Outcome of Patients with HIV Infection and Respiratory Failure Admitted to the Intensive Care Unit
title_sort etiology and outcome of patients with hiv infection and respiratory failure admitted to the intensive care unit
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3771454/
https://www.ncbi.nlm.nih.gov/pubmed/24065988
http://dx.doi.org/10.1155/2013/732421
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