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Acute respiratory failure has a high mortality in patients with acquired immunodeficiency syndrome (AIDS). This study was undertaken to determine the etiology of acute respiratory failure and the outcome of children with AIDS and AIDS-related complex. Records of 31 children with AIDS or AIDS-related complex admitted to the pediatric intensive care unit for acute respiratory failure throughout a 46-month period were reviewed. Acute respiratory failure was due to Pneumocystis carinii pneumonia in 13, cytomegalovirus pneumonia in six, bacterial pneumonia in five, severe bacterial sepsis in four, Candida pneumonia in two, and a giant cell pneumonia in one patient. In addition, 11/19 patients with acute respiratory failure due to P carinii pneumonia or cytomegalovirus had superinfections with bacteria or Candida. Of the total of 19 primary and secondary bacterial infections, Pseudomonas aeruginosa was responsible in ten and Klebsiella pneumoniae in three children. Five children (16%) survived until pediatric intensive care unit discharge; three died within 6 months. The causes of acute respiratory failure were not significantly different in survivor and nonsurvivor groups. It is concluded that, in addition to P carinii pneumonia and cytomegalovirus pneumonia, bacterial infections (especially due to Pseudomonas and other Gram-negative organisms) are important causes of respiratory failure. The high mortality and grim ultimate prognosis seen may have implications for pediatricians attempting to identify the proper limits of medical intervention for this group of patients.
D D Vernon, and
B H Holzman, and
P Lewis, and
G B Scott, and
J A Birriel, and
M B Scott
May 1995,
The Journal of pediatrics,
D D Vernon, and
B H Holzman, and
P Lewis, and
G B Scott, and
J A Birriel, and
M B Scott
September 1986,
Taiwan yi xue hui za zhi. Journal of the Formosan Medical Association,
D D Vernon, and
B H Holzman, and
P Lewis, and
G B Scott, and
J A Birriel, and
M B Scott
May 1991,
Clinical pharmacology and therapeutics,
D D Vernon, and
B H Holzman, and
P Lewis, and
G B Scott, and
J A Birriel, and
M B Scott
December 1988,
Proceedings of the National Academy of Sciences of the United States of America,
D D Vernon, and
B H Holzman, and
P Lewis, and
G B Scott, and
J A Birriel, and
M B Scott
June 1987,
Medicina clinica,
D D Vernon, and
B H Holzman, and
P Lewis, and
G B Scott, and
J A Birriel, and
M B Scott
January 1988,
Pediatric pulmonology,
D D Vernon, and
B H Holzman, and
P Lewis, and
G B Scott, and
J A Birriel, and
M B Scott
July 1989,
The Journal of urology,
D D Vernon, and
B H Holzman, and
P Lewis, and
G B Scott, and
J A Birriel, and
M B Scott
December 1986,
Archives of otolaryngology--head & neck surgery,
D D Vernon, and
B H Holzman, and
P Lewis, and
G B Scott, and
J A Birriel, and
M B Scott
May 1986,
Critical care medicine,
D D Vernon, and
B H Holzman, and
P Lewis, and
G B Scott, and
J A Birriel, and
M B Scott
February 1986,
Annals of internal medicine,
