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Tracheotomy in patients with acquired immunodeficiency syndrome. Is it necessary?
G R Thomas1, E M Myers, A Nunez
1Department of Otolaryngology-Head and Neck Surgery, Georgetown University School of Medicine, Washington, DC.
Objective:
Patients with acquired immunodeficiency syndrome (AIDS) who develop respiratory failure and require mechanical ventilation have mortality rates of 85%. Tracheotomies are performed in this patient population for prolonged intubation. However, to date, objective data on tracheotomy in patients with AIDS are lacking. Tracheotomy in ventilator-dependent patients with AIDS presents risks to patients and exposes surgeons, nurses, and operating room personnel to human immunodeficiency virus-infected blood.
Design:
Given these considerations, we retrospectively reviewed our experience with tracheotomy in 10 intubated and ventilator-dependent patients with AIDS.
Conclusions:
Our study shows a mortality rate of 100%. We identify predictive factors and a prognosis that may aid in the treatment of these patients.