Vallada MG, Moreira MC, Peron PP, Marques HH; International Conference on AIDS.

Int Conf AIDS. 1998; 12: 1109 (abstract no. 60591).

Instituto Da Crianca-HCFMUSP, Brazil.

BACKGROUND: There is a sharp controversy about the admission of HIV infected children at the Intensive Care Unit (ICU), specially in developing countries, where the lack of resources is greater, about the cost-effectiveness for a stated poor prognosis due to the HIV infection. METHODS: The charts of every HIV infected child that was admitted at the ICU between January, 1992 and December, 1997 were retrospectively revised. RESULTS: Throughout this period, 26 children accounted for 33 admissions. The male gender represented 21 of the 26 patients. The HIV serology was already known at the time of the admission at the ICU in 21 of the children. The age varied between 1 and 124 months (median 19.5). The CD4 cell count was below 200 cells/mm3 in 14 patients, 17 were taking antiretroviral therapy and 14 were taking P. carinii prophylaxis. Severe malnutrition was present in 21 children, leucopenia in 11 and thrombocytopenia (less than 100,000 platelets) in other 11. In 12 of the 33 admissions, the patients came from the Emergency Department, while the other 21 were already in the Pediatric Ward. Pneumonia was the most common diagnosis at the admission. The length of stay at the ICU varied between 1 and 24 days (average 6.24 and median 5); among the 13 admissions in which the patients died, the median of the length of stay was 2 days, while among the other 20 in which the patients were discharged, the median of the length of stay was 6 days. The time of survival after the ICU discharge varied between 15 days and 72 months (average 15 months, median 8 months) PRISM-III Score was calculated and varied between 6 and 23 in the group of children that died (average 12.07; median 10; standard deviation (SD) 5.62) and between 0 and 24 months in the group that was discharged (average 8.6; median 8; SD 4.06). CONCLUSION: The mortality rate in this study was 39%, demonstrating that the presence of HIV infection is not determinant of a bad prognosis, neither of a prolonged hospitalization and, therefore, it should not be used as a reason for the denial of admission of these children at the ICU.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• CD4 Lymphocyte Count
• Child
• HIV Infections
• HIV Seropositivity
• Humans
• Intensive Care Units
• Male
• Patient Discharge
• Pneumonia
• Prognosis

Other ID:

• 98410211

UI: 102232540

From Meeting Abstracts