Children with human immunodeficiency virus admitted to a paediatric intensive care unit in the United Kingdom over a 10-year period

Cooper, Sian; Lyall, Hermione; Walters, Sarah; Tudor‐Williams, Gareth; Habibi, Parviz; Munter, Claudine De; Britto, Joseph; Nadel, Simon

doi:10.1007/s00134-003-2074-7

Cited by 28 publications

(14 citation statements)

References 11 publications

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“…In 2004 Cooper et al documented that HIV-infected children admitted to a PICU in London had a 38% mortality when every effort is made to treat such children (20). The actual mortality of these infants beyond the PICU into the first year of life is a subject of an ongoing study.…”

Section: Resultsmentioning

confidence: 99%

Outcome of human immunodeficiency virus–exposed and –infected children admitted to a pediatric intensive care unit for respiratory failure*

Kitchin

Masekela

Becker

et al. 2012

Pediatric Critical Care Medicine

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Section: Resultsmentioning

confidence: 99%

Outcome of human immunodeficiency virus–exposed and –infected children admitted to a pediatric intensive care unit for respiratory failure*

Kitchin

Masekela

Becker

et al. 2012

Pediatric Critical Care Medicine

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“…In the UK, it remains the leading cause of admission to an intensive care unit in HIVpositive children [3]. PCP is also found in children with innate immunodeficiency, such as SCID, and due to iatrogenic immunosuppression following chemotherapy or transplantation [4].…”

Section: Discussionmentioning

confidence: 99%

An infant with pneumonia, failure to thrive and persistent radiographical changes

Thompson

Saglani²,

Bush³

2007

Eur Respir J

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A 9-month-old male presented to his local hospital with a 2-week history of diarrhoea and vomiting and a 48-h history of tachypnoea and grunting. He was afebrile on admission and oxygen saturation was 96% in room air, but he had mild respiratory distress and tachypnoea. Inflammatory markers were not raised but a chest radiograph showed left-sided collapse and consolidation. Treatment was commenced with i.v. antibiotics. The patient's respiratory pattern worsened 24 h after admission and his oxygen saturation dropped to 90%, requiring 2.5 L?min -1 supplemental oxygen. His diarrhoea settled after 48 h but he continued to have intermittent vomiting.The patient was an only child, born at term to unrelated parents and had no significant illnesses until this episode. He had a complete immunisation history and was achieving his developmental milestones normally. Weight gain was along the 50th centile for the first 6 months but had dropped down towards the second centile since weaning had occurred. There was no other family history of note.After 2.5 weeks, he still had a significant supplemental oxygen requirement and persisting left-sided chest radiograph abnormalities, despite a change to broader spectrum antibiotics, and so was transferred to the Royal Brompton Hospital (London, UK) for a respiratory opinion. On arrival, he had no significant fever and over the next 4 days he became normally saturated in room air. Antibiotics were stopped as his clinical condition improved.Initial investigations on presentation were normal (table 1), including white cell count differential and blood film. Early morning gastric washings were negative, as were Mantoux and sweat tests. Blood, urine and stool cultures, nasopharyngeal aspirate (NPA) for viral immunofluorescence and mycoplasma serology were all negative. Radioallergosorbent test for common allergens was negative as was a coeliac screen.The patient remained mildly tachypnoeic, despite the absence of an oxygen requirement. A chest radiograph was taken at this time ( fig. 1). Following this a high-resolution computed tomography (HRCT) scan was performed ( fig. 2).

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“…The ethical issues surrounding the PICU admission of children with HIV infection in the developing world were reviewed by Jeena et al 37 Even within the context of the developed world there was significant mortality associated with admission of HIV infected children to PICU. 22 Not only was there a high early and late mortality in HIV infected children admitted to the PICU, but they had longer duration of stay than other patients. 6 Subsequently antiretroviral therapy for children has become available in South Africa and in many other parts of the world.…”

Section: Ethical Issues For Hiv In the Picumentioning

confidence: 99%

“…In a variety of reports respiratory infections accounted for 71 -77% of admissions, 6,22,23 with pneumocystis pneumonia accounting for 38% to 45%. 6,22,23 Outcomes for children with pneumocystis pneumonia (PCP) have improved substantially with the use of high dose cotrimoxazole therapy, lung protective ventilatory patterns and steroids. The use of steroids for PCP.…”

Section: Hiv In the Picumentioning

confidence: 99%

Managing HIV in the PICU — The experience at the red cross War Memorial Children’s Hospital in Cape Town

2008

Indian J Pediatr

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The HIV pandemic has affected children throughout the developing world. This article describes the experience of the Paediatric Intensive Care Unit at the Red Cross War Memorial Children's Hospital in Cape Town, South Africa. Over the last 20 years we have improved our management of HIV infected children requiring intensive care admission. In the absence of anti-retroviral therapy, long term outcomes from PICU admission of HIV infected children have not improved significantly, and it is debatable whether PICU admission is justified. Once anti-retroviral therapy is available to children, there may be significant improvements in outcome and possible affected children should be admitted to the PICU if resources are available.

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Children with human immunodeficiency virus admitted to a paediatric intensive care unit in the United Kingdom over a 10-year period

Cited by 28 publications

References 11 publications

Outcome of human immunodeficiency virus–exposed and –infected children admitted to a pediatric intensive care unit for respiratory failure*

Outcome of human immunodeficiency virus–exposed and –infected children admitted to a pediatric intensive care unit for respiratory failure*

An infant with pneumonia, failure to thrive and persistent radiographical changes

Managing HIV in the PICU — The experience at the red cross War Memorial Children’s Hospital in Cape Town

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