Parrot A, Lafon B, Bedos JP, Houacine S, Denis M, Mayaud C, Akoun G; International Conference on AIDS.
Int Conf AIDS. 1991 Jun 16-21; 7: 228 (abstract no. W.B.2184).
Tenon Hospital - Paris - France
In spite of the use of adjuvant steroids, 30 % of severe Pneumocystis carinii pneumonia (PNC.P) in AIDS pts are still fatal. Consequently in such pts, early changes in therapy should be adopted, which presupposed the identification of early prognostic factors. The OBJECTIVE of this study is to appreciate the prognostic value of the early evolution of serum lactatedehydrogenase levels (LDH). METHOD: This study concerns 37 pts hospitalized from 1.07.89 to 1.07.90 in ICUs because of severe PNC.P (PaO2 less than 50 mmHg on room air). All these pts received TMP (20 mg/kg/d) - SMZ (100 mg/kg/d) and methyprednisolone (240 mg/d X 3 d, 120 mg/d X 3 d, 60 mg/d X 3 d). For each pt, LDH was evaluated at D 0 and D 7 of treatment (normal value: 160-500 mU/ml). For results, 2 groups of pts are considered here: G 1, n = 27 pts with a favorable evolution; G II, n = 10 pts with a fatal evolution (n = 9) or prolonged controlled ventilation (n = 1). Both groups were similar at D 0 for age (41 +/- 2 yrs), PaO(2) (41 +/- 3 mmHg) and % PMN in BAL (17 +/- 10%). RESULTS: TABULAR DATA, SEE ABSTRACT VOLUME. DISCUSSION AND CONCLUSION: In our series, even if there are statistical differences in the early evolution of LDH between the two groups, this evolution is of no individual prognostic value; indeed, increasing LDH is observed in only 2/27 G I pts (8%) and 3/10 G II (30%), and regularly decreasing LDH is observed in 25 G I pts (92%) but also in 7 G II pts (70% with LDH = 1070 + 250 mU at D 7).
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Adjuvants, Immunologic
- Adjuvants, Pharmaceutic
- Humans
- L-Lactate Dehydrogenase
- Pneumonia, Pneumocystis
- Respiration, Artificial
- Steroids
- diagnosis
- organization & administration
Other ID:
UI: 102192788
From Meeting Abstracts