THE OUTCOME OF MECHANICAL VENTILATION IN PATIENTS WITH AN AIDS-ASSOCIATED PRIMARY EPISODE OF PNEUMOCYSTIS-CARINII PNEUMONIA

The justification for mechanical ventilation (MV) of patients with an AIDS-related Pneumocystis carinii pneumonia (PCP) has been submitted to debate, due to poor prognosis of AIDS patients. Since the start of the epidemic our policy has been to offer MV to this group of patients when needed. The first 28 patients who received MV because of an AIDS-related primary episode of PCP were reviewed (28/126 patients; 22%). 14 of these patients were discharged from hospital. Their median survival time was 20.5 (range 7.8-37.1) months, dated from the episode. Life table analysis of these patients and patients with a less severe primary episode of AIDS-related PCP treated in the same period, did not reveal any difference in long-term survival. We were not able to demonstrate any prognostic factor separating MV patients who survived from those who died. On the basis of these results we recommend that MV is offered to all patients with a life threatening AIDS-associated primary episode of PCP.