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[Admissions of patients with AIDS to pediatric intensive care units]
M Casanova Román1, J Ríos Hurtado, F J García Martín
1Unidad de Cuidados Intensivos Pediátricos. Unidad de Enfermedades Infecciosas e Inmunodeficiencias. Departamento de Pediatría. Hospital Materno-Infantil. Complejo Hospitalario Universitario Carlos Haya. Málaga.
Insights
Pediatric intensive care unit (PICU) admissions for children with acquired immunodeficiency syndrome (AIDS) often present with respiratory failure. Early diagnosis and treatment are crucial for improving survival rates in these critically ill children.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Immunology
Context:
- Acquired immunodeficiency syndrome (AIDS) in children presents unique challenges in intensive care settings.
- Understanding clinical features is vital for timely intervention and management.
- Pediatric intensive care units (PICUs) manage critically ill children with complex conditions.
Purpose:
- To delineate the key clinical characteristics of pediatric patients with AIDS admitted to the PICU.
- To identify common reasons for PICU admission and outcomes in this population.
Summary:
- A retrospective study analyzed 13 PICU admissions for 12 children with AIDS between 1988 and 1997.
- Respiratory failure was the primary reason for admission (6 patients), often requiring mechanical ventilation.
- Opportunistic infections were common, with some children diagnosed with HIV infection during their PICU stay.
Impact:
- Findings highlight the importance of high clinical suspicion for opportunistic infections in critically ill children.
- The study suggests that with advancements like highly active antiretroviral therapy, HIV-infected children are increasingly suitable for PICU care.
- Improved survival rates underscore the effectiveness of intensive care management for pediatric AIDS patients.
Objective:
To describe the most significant clinical features of children with acquired immunodeficiency syndrome who required admission to a pediatric intensive care unit (PICU).
Methods:
Retrospective study of 12 patients with AIDS who required 13 admissions, between January 1988 and December 1997.
Results:
Mean age at admission was 15 months (1 month-6 years). Seven patients were under 1 year of age; four were diagnosed during their stay in the unit. The most common reason for admission was respiratory failure (six patients), followed by cardiac failure. Six patients needed mechanical ventilation (5 for respiratory failure). Two patients died during their stay, one of pneumonia due to Pneumocystis carinii infection and one of septic shock.
Conclusions:
One-third of patients was diagnosed with HIV Infection during their stay at the PICU. Opportunistic infection was the initial manifestation of the disease. Consequently, with this type of infection, clinical suspicion should be high. The survival rate of up to 84.6% of the admissions to our unit as well as the new, highly active antiretroviral therapy, generally make HIV-infected children suitable for treatment in intensive care units.
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