Chest
Clinical Investigations in Critical CareIntensive Care in Patients With HIV Infection in the Era of Highly Active Antiretroviral Therapy
Section snippets
Materials and Methods
This study was approved by the Beth Israel Medical Center Institutional Review Board. All patients admitted to the Medical ICU were studied prospectively from January through June 2001 (ie, the post-HAART era), and their characteristics were compared with those of patients admitted to the same unit from November 1991 through October 1992 (ie, the pre-HAART era), which were published previously.3 Beth Israel Medical Center is an 847-bed, urban, acute care hospital and has been a designated AIDS
Results
During the 6-month study period, there were 441 admissions to the ICU. In all, 96 patients with HIV were admitted to the ICU over a 1-year period, starting October 2000. In the 6-month period of intensive prospective review, 53 HIV-seropositive patients had a total of 63 ICU admissions (14% of all admissions). This group was compared to 65 different patients admitted to the same ICU during the same 1-year period approximately 10 years earlier. The characteristics of the patients admitted to the
Discussion
Before HAART became the standard of care, most patients with HIV infection had progressive immune compromise and eventually succumbed to opportunistic infection, AIDS-associated malignancy, or HIV-associated dementia and wasting. Questions about whether to provide intensive care were inevitable, and the medical literature described the incidences and outcomes of the critical illnesses that HIV-infected persons developed. With the use of HAART, HIV-infected persons enjoyed a reduced risk of
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Cited by (88)
Characteristics and outcomes of HIV-1-infected patients with acute respiratory distress syndrome
2015, Journal of Critical CareThe burden of sepsis in critically ill human immunodeficiency virus-infected patients-a brief review
2015, Brazilian Journal of Infectious DiseasesManagement of Persons Infected with Human Immunodeficiency Virus Requiring Admission to the Intensive Care Unit
2013, Critical Care ClinicsCitation Excerpt :In 1 multicentre prospective cohort study of patients with HIV including 4298 patient-years of follow-up, 5% of hospital admissions included an ICU admission, and as in other studies, a requirement for mechanical ventilation for PCP or other respiratory conditions was associated with poor outcome.3 However, survival has improved substantially in the HAART era,4–6 and is now believed to be similar to that for non-HIV patients at similar levels of illness severity.7–9 Although much of this improvement is likely related to the success of ART itself, improvements in critical care medicine such as low tidal volume and high-frequency ventilation also seem to have played an important role.10
Critical Care of Persons Infected with the Human Immunodeficiency Virus
2013, Clinics in Chest MedicineCitation Excerpt :Neurologic problems, such as AIDS-related cryptococcal meningitis (CM) and AIDS-unrelated events such as intracranial hemorrhage, account for 12% to 26% of all ICU admissions.4,8,10,12,14,19 About half of the ICU admissions are now non-AIDS-related.7–10,12,24 Non-AIDS admissions are varied in their cause and include admissions for gastrointestinal bleeding, cardiac disorders, metabolic complications, or those that follow elective surgery and trauma.
Supported by a grant from the Alan & Barbara Mirken Pulmonary Fund.