ABSTRACT
A three year prospective study of a total of 62 critically ill HIV patients in MICU showed a rising percentage from 0.86 in 1992 to 3.17 in 1994. Four major presentations were observed, neurological-20 patients (32.5%), sepsis syndrome-18 (29%), poisoning-10 (16.1%) and miscellaneous-14 (22.6%). Acute poisoning emerged as the most important preventable indication for MICU admissions. Interventions like CVP and haemodynamic monitoring-25 patients, endotracheal intubation-18, mechanical ventilation-14, tracheostomy-3, haemodialysis-3 were done when indicated. The mortality of the 14 ventilated patients was high at 92.9% compared to the overall HIV mortality of 46.8%. This study shows that critically ill HIV patients do deserve intensive care management with optimum infection control precautions. Survival of 53.2% is noteworthy in a resource stretched set up.
Subject(s)
Adult , Aged , Child , Disease Transmission, Infectious/statistics & numerical data , Female , HIV Antibodies/analysis , HIV Infections/epidemiology , HIV-1/immunology , HIV-2/immunology , Hospital Mortality , Humans , India/epidemiology , Intensive Care Units/statistics & numerical data , Male , Middle Aged , Prospective Studies , Survival Rate/trendsSubject(s)
Anti-Bacterial Agents/therapeutic use , Digitalis/therapeutic use , Endocarditis, Bacterial/diagnosis , Female , Humans , Middle Aged , Phytotherapy , Plants, Medicinal , Plants, Toxic , Pseudomonas/isolation & purification , Pseudomonas Infections/diagnosis , Ventricular Dysfunction, Right/diagnosisABSTRACT
One hundred patients with Multiple System Organ Failure (MSOF) were studied. The precipitating factors were infections, poisoning, metabolic disorders, surgical disorders and cardiac arrest resulting in an overall mortality of 65%. Mean inpatient stay was 3.86 days, being significantly longer in patients who survived (6.25 days). Age, sex, addictions and premorbid health did not affect outcome. GIT (89%), CNS (81%) and Liver failure (62%) were seen most commonly. Highest mortalities were observed with RS (81.2%), CVS (80.37%) and CNS (76.5%). The mortality with 2,3,4,5,6 and 7 OSF was 8.3%, 18.7%, 70%, 92%, 100% and 100% respectively. The mortality was highest (50.76%) on the first day of MSOF and during the initial 48 hours of the total duration of disease. The method proposes an easily reproducible way to evaluate severity of illness and predicting outcome in acute MSOF.