Back to Search
Start Over
Independent risk of mechanical ventilation for AIDS-related Pneumocystis carinii pneumonia associated with bronchoalveolar lavage neutrophilia.
- Source :
-
Respiratory medicine [Respir Med] 2001 Aug; Vol. 95 (8), pp. 661-5. - Publication Year :
- 2001
-
Abstract
- The use of mechanical ventilation (MV) for AIDS-related Pneumocystis carinii pneumonia (PCP) has varied over time. The introduction of adjunctive corticosteroid therapy has changed the pathophysiology of PCP. In the present study, we attempted to identify factors predictive of severe respiratory failure requiring MV amongst patients with PCP treated in the era of adjunctive corticosteroid therapy. Furthermore, we studied factors associated with survival in relation to MV. Of 170 consecutive patients with AIDS-related PCP, 18 (11%) required MV. Thirteen of 18 ventilated patients died (72%). In a logistic regression analysis, higher age, increased bronchoalveolar lavage (BAL) neutrophilia and a positive BAL cytomegalovirus CMV culture were associated with the need of MV. In multivariate analyses, only BAL neutrophilia remained independently predictive of mechanical ventilation. In conclusion, short-term mortality remained high after the introduction of adjunctive corticosteroid therapy. BAL neutrophilia may be a useful prognostic marker to identify patients at high risk of requiring mechanical ventilation.
- Subjects :
- AIDS-Related Opportunistic Infections immunology
AIDS-Related Opportunistic Infections therapy
Adult
Aged
Bronchoalveolar Lavage Fluid virology
Chi-Square Distribution
Cohort Studies
Cytomegalovirus isolation & purification
Female
Humans
Male
Middle Aged
Multivariate Analysis
Pneumonia, Pneumocystis immunology
Pneumonia, Pneumocystis therapy
Risk Factors
Statistics, Nonparametric
Survival Rate
AIDS-Related Opportunistic Infections mortality
Bronchoalveolar Lavage Fluid immunology
Neutrophils physiology
Patient Selection
Pneumonia, Pneumocystis mortality
Respiration, Artificial
Subjects
Details
- Language :
- English
- ISSN :
- 0954-6111
- Volume :
- 95
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Respiratory medicine
- Publication Type :
- Academic Journal
- Accession number :
- 11530954
- Full Text :
- https://doi.org/10.1053/rmed.2001.1119