All patients over 18 years old with AIDS and respiratory failure admitted to the ICU, either from the emergency department or transferred from medical wards, were included sequentially. HIV infection was either previously known or newly diagnosed. AIDS patients with CD4 count < 200 cells/µL or with clinical AIDS-defining conditions. Those diagnosed within two months before admission to ICU and had not received cART were defined as newly diagnosed HIV infection. Respiratory failure was defined as the partial pressure of arterial oxygen (PaO2) ≤ 60 mmHg on room air or the ratio between PaO2 and inspired oxygen fraction (PaO2/FiO2) ≤ 300 mmHg. Patients who did not have pulmonary infections, accepted invasive mechanical ventilation (IMV) before ICU admission, and had an ICU stay of fewer than 24 hours were excluded. We included patients with respiratory failure caused by pulmonary infections. Pulmonary infections were based on clinical symptoms and abnormalities on computed tomography scan, along with the morphological identification of the organism in induced sputum, low tracheal aspiration or bronchoalveolar lavage fluid if accessible. The samples were cultured for bacteria and fungi. Pneumocystis jirovecii organisms were identified with staining (eg, Giemsa or Gomori-Grocott) or immunofluorescence on specimens.14 (link) CMV DNA was tested using quantitative real-time polymerase chain reaction. What’s more, we did laboratory tests to evaluate for atypical bacterial pathogens like mycoplasma or legionella.
Only the first episode was evaluated in patients with multiple episodes admitted to the ICU for respiratory failure during their hospitalization.
Only the first episode was evaluated in patients with multiple episodes admitted to the ICU for respiratory failure during their hospitalization.
