Outcome of Intensive Care in Patients With HIV Infection

Palo, Vera A. De; Millstein, Barbara; Mayo, Paul H.; Salzman, Steve H.; Rosen, Mark J.

doi:10.1378/chest.107.2.506

Cited by 88 publications

(69 citation statements)

References 22 publications

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“…However, in this study, just under half the admissions were with a variety of nonrespiratory conditions, which is consistent with the findings of De Palo et al [10] whose prospective study found 46% of cases were admitted to ICU with nonrespiratory disease.…”

Section: Discussionsupporting

confidence: 93%

ICU admission in patients infected with the human immunodeficiency virus — a multicentre survey

et al. 1999

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We conducted a retrospective study to assess the reasons for admission to the intensive care unit, and subsequent outcome, in patients infected with the human immunodeficiency virus (HIV). Four hospitals in the south of England participated, all with specialist HIV units. Data were collected on 127 patients admitted to ICU on 133 separate occasions between June 1993 and October 1997. The mean age on admission was 38 years (range 23–60 years). Ninety‐four patients (70.7%) were documented HIV‐positive before admission and 36 (27%) were diagnosed HIV‐positive for the first time during admission; 36.1% were admitted with Pneumocystis carinii pneumonia. Overall ICU mortality was 33%, in‐hospital mortality was 56% and the eventual mortality at the end of follow‐up (March 1998) was 72%. Survival was highest in those admitted with respiratory HIV‐related disease or HIV‐unrelated illness. Associations with poor outcome included a prior AIDS‐defining illness, a CD4 cell count of less than 100 cells.ml−1 and admission secondary to sepsis.

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Section: Discussionsupporting

confidence: 93%

ICU admission in patients infected with the human immunodeficiency virus — a multicentre survey

et al. 1999

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“…14,15 In our study, respiratory failure carried a hospital mortality rate of 46%; it was higher (59%) when the underlying cause of respiratory failure was PCP than it was for other causes of respiratory failure (38%). However, 2 recent studies 16,17 conducted in France reported a remarkably low mortality rate of 25% to 34% for respiratory failure and a mortality rate of only 22% to 25% when PCP was the cause of the respiratory failure.…”

Section: Commentmentioning

confidence: 56%

“…[14][15][16][17] During the first decade of the epidemic, about two thirds of admissions to the ICU among patients with AIDS were for respiratory failure, and roughly half of all admissions were specifically due to respiratory failure from PCP. 8,[21][22][23] Recently, in our study and others, [14][15][16][17] respiratory failure from PCP or from other causes has made up a smaller, but still significant, proportion of admissions to ICUs among patients with AIDS.…”

Section: Commentmentioning

confidence: 99%

“…Given the changes in populations at risk, spectrum of illness, and therapies for HIV disease, there is reason to believe that the indications for admission to the ICU have changed during the years and that the prognosis of patients with acquired immunodeficiency syndrome (AIDS) requiring intensive care has changed as well. Few recent studies [14][15][16][17] have addressed this issue, and the numbers of patients in these studies were modest. We collected data on all patients infected with HIV admitted for intensive care at San Francisco General Hospital, San Francisco, Calif, during the 4-year period from January 1, 1992, to December 31, 1995, to address these issues.…”

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confidence: 99%

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Outcomes of Intensive Care for Patients With Human Immunodeficiency Virus Infection

Nickas¹,

Wachter²

2000

Arch Intern Med

102

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“…In patients with advanced AIDS, 8% had CM (De Palo et al, 1995). A similar proportion was found in hemophiliacs with AIDS (Jacob et al, 1993).…”

mentioning

confidence: 58%

Cardiac Dysfunction Occurs in the HIV-1 Transgenic Mouse Treated with Zidovudine

Lewis

Grupp

et al. 2000

Laboratory Investigation

129

107

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SUMMARY:Cardiomyopathy in AIDS is an increasingly important clinical problem. Mechanisms of AIDS cardiomyopathy were explored using AIDS transgenic mice that express replication-incompetent HIV-1 (NL4 -3⌬ gag/pol). Transgenic and FVB/n mice (n ϭ 3 to 6 per cohort) received water ad libitum with and without zidovudine (3Ј-azido-2Ј,3Ј-deoxythymidine; AZT; 0.7 mg/ml) for 21 or 35 days. After 21 days, echocardiographic studies were performed and abundance of mRNA for cardiac sarcoplasmic reticulum calcium ATPase (SERCA2), sodium calcium exchanger (NCX1), and atrial natriuretic factor were determined individually using Northern analysis of extracts of left ventricles. After 35 days, contractile function and relaxation were analyzed in isolated work-performing hearts. Histopathological and ultrastructural (transmission electron microscopy) changes were identified. After 21 days, molecular indicators of cardiac dysfunction were found. Depressed SERCA2 and increased atrial natriuretic factor mRNA abundance occurred in left ventricles from AZT-treated transgenic mice. NCX1 abundance was unchanged. Eccentric left ventricle hypertrophy was determined echocardiographically. After 35 days, cardiac dysfunction was worst in AZT-treated and AZT-untreated transgenic mice. Decreases in the first derivative of the maximal change in left ventricle systolic pressure with respect to time (ϩdP/dt) occurred in transgenic mice with and without AZT. Increased half-time of relaxation and ventricular relaxation (ϪdP/dt) occurred in AZT-treated and -untreated transgenic mice. Increased time to peak pressure was found only in AZT-treated transgenic mice. In AZT-treated FVB/n mice, ϪdP/dt was decreased. Ultrastructurally, mitochondrial destruction was most pronounced in AZT-treated transgenic mice, but also was found in AZT-treated FVB/n mice. Transgenic mice that express HIV-1 demonstrate cardiac dysfunction. AZT treatment of FVB/n mice causes mitochondrial ultrastructural alterations that are similar to those in other species. In transgenic mice, AZT treatment worsens molecular and ultrastructural features of cardiomyopathy. HIV-1 constructs and AZT each contribute to cardiac dysfunction in this murine model of AIDS cardiomyopathy.

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Outcome of Intensive Care in Patients With HIV Infection

Cited by 88 publications

References 22 publications

ICU admission in patients infected with the human immunodeficiency virus — a multicentre survey

ICU admission in patients infected with the human immunodeficiency virus — a multicentre survey

Outcomes of Intensive Care for Patients With Human Immunodeficiency Virus Infection

Cardiac Dysfunction Occurs in the HIV-1 Transgenic Mouse Treated with Zidovudine

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