Outcome of pediatric (P) HIV patients requiring admission to the pediatric critical care unit

Edvwd E.conway Jr., Dayid Rubin, Lawis Singer

Research output: Contribution to journalArticle

Abstract

Overall morbidity and mortality figures for pédiatrie (P) patients infected with HIV requiring critiol cwi (CC) have not been reported to date. Extrapolation of data from adult studies is not appropiate for P pts. Methods: We reviewed admission data on an P HIV patients (n = 183) admitted to the PICU during the period 1/87 through 12/94. We reviewed admitting diagnoses, age. race. sex, length of stay, need tor mechanical ventilation and mortality. Pts were subclassiffed according to age and diagnosis. Results: The number of admissions remained constant throughout the study period at 23.0+/-2.1/yr. There was no difference in the number of males/Temales. 45% of pts were Hispanic. 38% Black. 2.7% White and ie.8% other. 84 (46%) of the pts were infants. 92 (50%) were children and 7 (4%) were adolescents. 59 (32%) of pts were admitted for pneumocystts carirm pneumonia (PCP), 68 (36%) for respiratory failure not caused by PCP, IS (8%) for neurologic disease, 20 (11%) lor sepsis and shock. 7 (4%) for gastrointestinal disease (Gl) and 16 (9%) tor other illnesses. 102 (55%) pts required mechanical ventilation and the mean length of ICU stay (LOS) was 10.8+/-12.8 days. Pts with PCP had a mean LOS of 17.5 days. Overall mortality was 25.1% (n=-46). PCP accounted for 24 deaths, rasp failure 6, neurologic 2, sepsis/shock 9, Gl 1 and other tor 4. The incidence of PCP was highest in the infant aged group 55% (n=48). There was a significant decrease in overall mortality during the last three years of the study. Infants were more likely to die from PCP or sepsis and shock than older children p<.05). Conclusions: Infants with PCP have the longest LOS and highest mortality. The decrease in mortality may be related to earlier diagnosis, antiviral therapy. PCP prophylaxsis, and the carry use of steroids in PCP. These (actors need further evaluation.

Original languageEnglish (US)
Pages (from-to)278
Number of pages1
JournalPediatric AIDS and HIV Infection
Volume7
Issue number4
StatePublished - 1996

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Patient Admission
Critical Care
Pneumonia
HIV
Pediatrics
Mortality
Length of Stay
Shock
Sepsis
Artificial Respiration
Gastrointestinal Diseases
Nervous System Diseases
Hispanic Americans
Respiratory Insufficiency
Nervous System
Antiviral Agents
Early Diagnosis
Steroids
Morbidity
Incidence

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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Outcome of pediatric (P) HIV patients requiring admission to the pediatric critical care unit. / E.conway Jr., Edvwd; Rubin, Dayid; Singer, Lawis.

In: Pediatric AIDS and HIV Infection, Vol. 7, No. 4, 1996, p. 278.

Research output: Contribution to journalArticle

E.conway Jr., Edvwd ; Rubin, Dayid ; Singer, Lawis. / Outcome of pediatric (P) HIV patients requiring admission to the pediatric critical care unit. In: Pediatric AIDS and HIV Infection. 1996 ; Vol. 7, No. 4. pp. 278.
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abstract = "Overall morbidity and mortality figures for p{\'e}diatrie (P) patients infected with HIV requiring critiol cwi (CC) have not been reported to date. Extrapolation of data from adult studies is not appropiate for P pts. Methods: We reviewed admission data on an P HIV patients (n = 183) admitted to the PICU during the period 1/87 through 12/94. We reviewed admitting diagnoses, age. race. sex, length of stay, need tor mechanical ventilation and mortality. Pts were subclassiffed according to age and diagnosis. Results: The number of admissions remained constant throughout the study period at 23.0+/-2.1/yr. There was no difference in the number of males/Temales. 45{\%} of pts were Hispanic. 38{\%} Black. 2.7{\%} White and ie.8{\%} other. 84 (46{\%}) of the pts were infants. 92 (50{\%}) were children and 7 (4{\%}) were adolescents. 59 (32{\%}) of pts were admitted for pneumocystts carirm pneumonia (PCP), 68 (36{\%}) for respiratory failure not caused by PCP, IS (8{\%}) for neurologic disease, 20 (11{\%}) lor sepsis and shock. 7 (4{\%}) for gastrointestinal disease (Gl) and 16 (9{\%}) tor other illnesses. 102 (55{\%}) pts required mechanical ventilation and the mean length of ICU stay (LOS) was 10.8+/-12.8 days. Pts with PCP had a mean LOS of 17.5 days. Overall mortality was 25.1{\%} (n=-46). PCP accounted for 24 deaths, rasp failure 6, neurologic 2, sepsis/shock 9, Gl 1 and other tor 4. The incidence of PCP was highest in the infant aged group 55{\%} (n=48). There was a significant decrease in overall mortality during the last three years of the study. Infants were more likely to die from PCP or sepsis and shock than older children p<.05). Conclusions: Infants with PCP have the longest LOS and highest mortality. The decrease in mortality may be related to earlier diagnosis, antiviral therapy. PCP prophylaxsis, and the carry use of steroids in PCP. These (actors need further evaluation.",
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