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Vol. 52. Issue 6.
Pages 537-541 (1 June 2000)
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Vol. 52. Issue 6.
Pages 537-541 (1 June 2000)
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Ingresos por sida en cuidados intensivos pediátricos
Admissions of patients with aids to pediatric intensive care units
Visits
5590
M. Casanova Román*, J. Ríos Hurtad, F.J. García Martín, G. Milano Manso, A. Martínez Valverde
Unidad de Cuidados Intensivos Pediátricos. Unidad de Enfermedades Infecciosas e Inmunodeficiencias. Departamento de Pediatría. Hospital Materno-Infantil. Complejo Hospitalario Universitario Carlos Haya. Málaga
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Objetivo

Describir las características clínicas más significativas de los niños con síndrome de inmunodeficienciencia adquirida (sida) que precisaron ingreso en una unidad de cuidados intensivos pediátricos (UCIP).

Material y métodos

Estudio retrospectivo de 12 pacientes con sida, que generaron 13 ingresos, entre enero de 1988 y diciembre de 1997.

resultados

La edad media de los pacientes al ingreso fue de 15 meses (1 mes-6 años), siendo 7 niños menores de un año y 4 se diagnosticaron de infección por el VIH durante su estancia en la unidad. La causa más frecuente de ingreso fue la insuficiencia respiratoria (6 casos), seguida de la insuficiencia cardíaca. Precisaron ventilación mecánica 6 casos. Dos pacientes fallecieron durante su ingreso, uno por neumonía por Pneumocystis carinii y otro por shock séptico.

Conclusiones

Un tercio de los pacientes fueron diagnosticados de infección por el VIH en la UCIP, resultando la infección oportunista la manifestación inicial de la enfermedad, por lo que se debe mantener una alta sospecha clínica ante la existencia de afección oportunista. La supervivencia de hasta el 84,6% de los pacientes ingresados en nuestra UCIP, unido a la actual terapia antirretroviral altamente activa, hacen a los pacientes con infección por el VIH subsidiarios, en general, de cuidados intensivos pediátricos.

Palabras clave:
Cuidados intensivos
Sida pediátrico
Pneumocystis carinii
Ventilación mecánica
Corticoïdes
Objective

To describe the most significant clinical features of children with acquired immunodeficiency syndrome who required admission to a pediatric intensive care unit (PICU).

Methods

Retrospective study of 12 patients with AIDS who required 13 admissions, between January 1988 and December 1997.

Results

Mean age at admission was 15 months (1 month-6 years). Seven patients were under 1 year of age; four were diagnosed during their stay in the unit. The most common reason for admission was respiratory failure (six patients), followed by cardiac failure. Six patients needed mechanical ventilation (5 for respiratory failure). Two patients died during their stay, one of pneumonia due to Pneu-mocystis carinii infection and one of septic shock.

Conclusions

One-third of patients was diagnosed with HIV infection during their stay at the PICU. Opportunistic infection was the initial manifestation of the disease. Consequently, with this type of infection, clinical suspicion should be high. The survival rate of up to 84.6% of the admissions to our unit as well as the new, highly active antiretroviral therapy, generally make HIV-infected children suitable for treatment in intensive care units.

Key words:
Intensive care
Pediatric AIDS
Pneumocystis carinii pneumonia
Mechanical ventilation
Corticosteroids
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Copyright © 2000. Asociación Española de Pediatría
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