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Intensive Care Medicine

, Volume 18, Issue 3, pp 155–159 | Cite as

Continuous positive airway pressure by face mask or mechanical ventilation in patients with human immunodeficiency virus infection and severePneumocystis carinii pneumonia

  • B. Gachot
  • B. Clair
  • M. Wolff
  • B. Régnier
  • F. Vachon
Originals

Abstract

We reviewed the records of 44 patients with AIDS who had 45 episodes of severePenumocystis carinii pneumonia (PCP). While 9 patients required intubation and mechanical ventilation (MV) on admission, continuous positive airway pressure (CPAP) by face mask was the initial measure in 36 episodes. There were 25 patients managed with CPAP alone, 23 of whom survived. Among the reasons for delayed intubation and MV (11 patients) was that treatment failure was strongly associated with non-survival, since all 6 such patients died. The in-hospital mortality for severe PCP in this study was 33% overall, and reached 65% for mechanically ventilated patients. The 1-year survival was 43% (95% confidence interval, 28%–58%). These data confirm the improved prognosis for patients with AIDS and severe PCP, and suggest that mask CPAP may be an adequate mean of ventilatory support in this setting.

Key words

Acquired immunodeficiency syndrome Pneumocystis carinii pneumonia Respiratory insufficiency Positive end expiratory pressure Critical care Steroids 

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Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • B. Gachot
    • 1
  • B. Clair
    • 1
  • M. Wolff
    • 1
  • B. Régnier
    • 1
    • 2
  • F. Vachon
    • 1
  1. 1.Intensive Care Unit, Infectious Diseases DepartmentBichat-Claude Bernard HospitalParisFrance
  2. 2.Clinique de Réanimation des Maladies InfectieusesGroupe Hospitalier Bichat-Claude BernardParisFrance

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