• Pediatric pulmonology · Aug 1994

    Comparative Study

    Improved outcome for young children with AIDS, Pneumocystis carinii pneumonia, and acute respiratory failure.

    • H R Wong and K R Chundu.
    • Division of Pediatric Medicine, Children's National Medical Center, Washington, District of Columbia.
    • Pediatr. Pulmonol. 1994 Aug 1; 18 (2): 114-8.

    ObjectiveTo describe the clinical course of children with acquired immunodeficiency syndrome, requiring mechanical ventilation secondary to Pneumocystis carinii pneumonia, with respect to intensive care unit outcome, long-term survival after intensive care unit discharge, and possible predictors of outcome.DesignRetrospective case series.SettingMultidisciplinary, tertiary, pediatric intensive care unit.PatientsThirteen consecutive patients accounting for 15 admissions to the intensive care unit, from September 1986 through December 1991, with the diagnoses of acquired immunodeficiency syndrome, P. carinii pneumonia, and acute respiratory failure requiring mechanical ventilation.ResultsAll patients were less than 2 years of age and acquired human immunodeficiency virus infection perinatally. Survival after 15 admissions to the intensive care unit was 60%. Mean (+/- SD) and median long-term survival for the nine intensive care unit survivors was 30 +/- 12.9 months and 27 months, respectively. Maximum oxygenation index and minimum partial pressure of arterial oxygen to fraction of inspired oxygen ratio were significantly different between survivors and nonsurvivors.ConclusionsYoung children with acquired immunodeficiency syndrome who develop acute respiratory failure secondary to P. carinii pneumonia and who require mechanical ventilation may have a better acute outcome and long-term survival than previously reported.

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