To study if there is a difference in the length of Mechanical Ventilation and overall mortality in patients with HIV requiring invasive mechanical ventilation as compared to patients with AIDS.
We performed a retrospective chart review of all the patients admitted to our institution with a diagnosis of Acute Respiratory Failure who required Invasive Mechanical intubation and had HIV disease based on the definition by CDC. The patients were further divided into HIV positive individuals and patients with AIDS as defined by CDC.
There were a total of 33 HIV patients requiring invasive mechanical ventilation admitted over a period of 5 years in our ICU. 14 had HIV and 19 had AIDS. There was no statistical difference in the age, sex, APACHE II score, admission Hematocrit, LDH, pH, and FIO2 in both the groups. There was a significantly higher rate of bacteremia(42% vs 7%), ARDS(15% vs 0%), and Septic shock(42% vs 7%) in the AIDS group. Length of Mechanical ventilation was 23.26 days in the AIDS group as compared to 4.43 days in the HIV group. Overall mortality was 57% in the AIDS group as compared to 7% in the HIV group.
AIDS patients have a significantly higher length of invasive mechanical ventilation and overall mortality as compared to HIV patients. Bacteremia, Septic shock and ARDS is much more prevalent in AIDS patients. Community Accquired Pneumonia was the most common cause for respiratory failure in both the groups.
Patients with only HIV seropositivity should undergo aggressive invasive mechanical ventilation,because the outcomes are very good in this population. Patients with AIDS are not candidates for invasive mechanical ventilation, thus non-invasive mechanical ventilation should be the primary consideration in this population. Clinicians should remember that invasive mechanical ventilation in patients with AIDS is associated with extended ICU stay, higher rates of complications and a very high mortality.
Hardeep Rai, No Financial Disclosure Information; No Product/Research Disclosure Information