[Intensive care for patients with the human immunodeficiency virus]

HIV infection is of special importance in Spain, occasionally requiring the use of intensive care units (ICU) in the management of these cases.

A retrospective review of the seropositive HIV patients was carried out of those requiring ICU admission in the authors' center over a three year period. Twenty-five patients were included, with the cause for admission into ICU, the clinical features, mortality and prognostic factors being reported.

Most of the patients presented as a risk behavior by intravenous drug addiction and did present AIDS prior to hospitalization. The most frequent cause for admission in the ICU was respiratory failure produced by germs other than Pneumocytis carinii, placing this microorganism in second place. The mean time of admission in the ICU was 10.8 days, with 88% requiring mechanical ventilation and 56% the use of vasoactive drugs. The ICU mortality was 48%. No survivor died posteriorly on the ward. Factors of bad prognosis were: less than 200 CD4 lymphocytes/mm3, low albumin levels and high creatinine in addition to the need for vasoactive drugs with no evidence of other data presenting statistical significance. Fourty-four percent of the survivors remain alive at 12 months of hospital discharge.

Respiratory failure produced by Pneumocystis carinii or by other germs is the most frequent cause for ICU admission of patients with HIV infection. Renal failure, lymphopenia, and hypoalbuminemia are predictors of mortality in almost 50% of the cases.