The role of assisted ventilation in survival after respiratory failure in children with AIDS.

OBJECTIVES

To determine the role of assisted ventilation in children with the acquired immunodeficiency syndrome and acute respiratory failure, and to identify any measurement or variable that predicted survival.

DESIGN

Retrospective study.

SETTING

Kings County (New York) Hospital Center, a tertiary-level inner-city municipal hospital.

PARTICIPANTS

Twenty-three children with acquired immunodeficiency syndrome who were endotracheally intubated and mechanically ventilated because of acute respiratory failure.

MEASUREMENTS/MAIN

RESULTS

There were 24 episodes of acute respiratory failure, as one patient survived a first episode and died during the second episode 2 years later. We failed to identify any measurement or variable that predicted survival. During 12 episodes (50%), the patients survived and were weaned from the ventilator.

CONCLUSIONS

Our findings indicate that a decision to avoid intubation and assisted ventilation in a child with acquired immunodeficiency syndrome and acute respiratory failure should not be made based merely on the presumption of a lethal outcome.