Acute Respiratory Failure in AIDS Patients

Consecutive AIDS patients with ARF admitted to the ICU or the Center for Infectious Diseases, Beijing Ditan Hospital, from April 2019 to March 2022, were screened daily. All enrolled patients in this study were inpatients infected with HIV and were considered to have AIDS as defined by the Centers for Disease Control and Prevention classification system for HIV infection [19 (link)]. A newly diagnosed HIV infection was diagnosed within two months before ICU admission and had not received HAART. If patients at the Center for Infectious Diseases met the inclusion criteria, they would transfer to the ICU. ARF was defined as the onset of respiratory symptoms within 72 h before enrollment, a ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen (PaO₂/ FiO₂) ≤ 300 mmHg or PaO₂ ≤ 60 mmHg with partial pressure on air with arterial carbon dioxide (PaCO₂) ≤ 50 mmHg and symptoms of respiratory distress (tachypnea > 25/min, labored breathing, and dyspnea at rest). In addition to ARF, the inclusion criteria were being between 18 to 70 and being willing to accept endotracheal intubation if needed.
Exclusion criteria were impending cardiopulmonary arrest, a disorder of consciousness, absence of airway protective gag reflex, upper airway obstruction, pregnancy or breastfeeding, other organ failures apart from ARF, consent withdrawal, used immunosuppressant, and enrolment in other research protocols. ARF caused by pneumothorax or massive pleural effusion, acute exacerbation of chronic lung disease, cardiogenic pulmonary edema, and central nervous system lesions were also excluded.