RESUMEN

En los ochenta el SIDA era una enfermedad considerada como letal. El tratamiento antirretroviral altamente activo (TARAA) ha disminuido de manera efectiva la morbilidad y mortalidad de los pacientes con infección por el virus de la inmunodeficiencia humana (VIH). La causa más común de ingreso a la Unidad de Cuidados Intensivos de pacientes con SIDA es la falla respiratoria, usualmente debida a neumonía por pneumocistis y a otras infecciones por agentes oportunistas. Otras causas importantes de ingreso a la Unidad de Cuidados Intensivos incluyen infecciones no relacionadas asociadas a VIH, hemorragia gastrointestinal, enfermedades cardiovasculares, sepsis, trauma, sobredosis de drogas y alteraciones del sistema nervioso central.

PALABRAS CLAVE

VIH-infecciones, cuidados intensivos, tratamiento antirretroviral altamente activo, .

REFERENCIAS

1. Centers for Disease Control: Pneumocystis pneumonia: Los Angeles. MMWR 1981; 30: 305-308.

2. ONUSIDA. http://www.unaids.org/en/KnowledgeCentre/HIVData/EpiUpdate/EpiUpdArchive/2007/default.asp

3. CONASIDA. http://www.salud.gob.mx/conasida/

4. Timsit JF. Open the intensive care unit doors to HIV-infected patients with sepsis. Crit Care 2005; 9: 629-30.

5. Vincent B, Timsit JF, Auburtin M, et al. Characteristics and outcomes of HIV infected patients in the ICU: impact of the highly active antiretroviral treatment era. Intensive Care Med 2004; 30: 859-66.

6. Narasimhan M, Posner AJ, DePalo VA, Mayo PH, Rosen MJ. Intensive care in patients with HIV infection in the era of highly active antiretroviral therapy. Chest 2004; 125: 1800-4.

7. Casalino E, Wolff M, Ravaud P, Choquet C, Bruneel F, Regnier B. Impact of HAART advent on admission patterns and survival in HIV-infected patients admitted to an intensive care unit. AIDS 2004; 18: 14-33.

8. Curtis JR, Bennett CL, Horner RE, et al. Variations in intensive care unit utilization for patients with human immunodeficiency virus-related Pneumocystis carinii pneumonia: Importance of hospital characteristics and geographic location. Crit Care Med 1998; 26: 668-675.

9. Wachter RM, Luce JM, Turner J, Volberding P, Hopewell PC. Intensive care of patients with the acquired immunodeficiency syndrome. Outcome and changing patterns of utilization. Am Rev Respir Dis 1986; 134(5): 891-6.

10. Wachter RM, Russi MB, Bloch DA, Hopewell PC, Luce JM. Pneumocystis carinii pneumonia and respiratory failure in AIDS: improved outcomes and increased use of intensive care units. Am Rev Respir Dis 1991; 143: 251-6.

11. Wachter RM, Luce JM, Safrin S, Berrios DC, Charlebois E, Scitovsky AA. Cost and outcome of intensive care for patients with AIDS, Pneumocystis carinii pneumonia, and severe respiratory failure. JAMA 1995; 273: 230-5.

12. Nickas G, Wachter RM. Outcomes of intensive care for patients with human immunodeficiency virus infection. Arch Intern Med 2000; 160: 541-7.

13. Morris A, Creasman J, Turner J, et al. Intensive care of human immunodeficiency virus infected patients during the era of highly active antiretroviral therapy. Am J Respir Crit Care Med 2002; 166: 262-7.

14. Nuesch R, Geigy N, Schaedler E, et al. Effect of highly active antiretroviral therapy on hospitalization characteristics of HIV-infected patients. Eur J Clin Microbiol Infect Dis 2002; 21: 684-87.

15. Afessa B, Green B. Clinical course, prognostic factors, and outcome prediction for HIV patients in the ICU: The PIP (pulmonary complications, ICU support, and prognostic factors in hospitalized patients with HIV) Study. Chest 2000; 118: 138-45.

16. Vargas-Infante YA, Guerrero ML, Ruiz-Palacios GM, Soto-Ramírez LE, et al. Improving outcome of human immunodeficiency virus-infected patients in a Mexican intensive care unit. Archives of Medical Research 2007; 38: 827-33.

17. Alves C, Nicolas JM, Miro JM, et al. Reapraisal of the a etiology and prognostic factors of severe acute respiratory failure in HIV patients. Eur Respir J 2001; 17: 87-93.

18. Huang L, Quartin A, Jones D, Havlir DV. Intensive care of patients with HIV Infection. N Engl J Med 2006; 355: 173-81.

19. Agostini C, Semenzato G. Immunologic effects of HIV in the lung. Clin Chest Med 1996; 17: 633-45.

20. Lane HC, Mansur H, Edgar LC, et al. Abnormalities of B cell activation and immunoregulation in patients with the acquired immunodeficiency syndrome. N Engl J Med 1983; 309: 453-58.

21. Mansur H, Ognibene FP, Yarchoan R, et al. CD4 counts as predictors of opportunistic pneumonia in human immunodeficiency virus type 1. Ann Inter Med 1989; 111: 223-31.

22. Rosen MJ, Clayton K, Schneider RF, et al. Intensive care of patients with HIV infection: Utilization, critical illnesses and outcomes. Am J Respir Crit Care Med 1997; 155: 67-71.

23. Gill JK, Greene L, miller R, et al. ICU admission in patients infected with the human immunodeficiency virus: a multicentre survey. Anaesthesia 1999; 54: 727-32.

24. Thomas CF, Limper AH. Pneumocystis pneumonia. N Engl J Med 2004; 350: 2487-98.

25. Huang L, Morris A, Limper AH, Beck JM, on behalf of the ATS Pneumocystis Workshop Partici. An official ATS workshop summary: Recent advances and future directions in Pneumocystis pneumonia (PCP). Proc Am Thorac Soc 2006; 3: 655-64.

26. Boiselle PM, Tocino I, Hooley RJ, et al. Chest radiograph diagnosis of Pneumocystis carinii pneumonia, bacterial pneumonia and pulmonary tuberculosis in HIV-positive patients: accuracy, distinguishing features, and mimics. J Thorac Imaging 1997; 12: 47-53.

27. Boiselle PM, Crans CA, Kaplan MA. The changing face of Pneumocystis carinii pneumonia in AIDs patients. Am J Roentgenol 1999; 172: 1301-9.

28. Murray JF, Felton CP, Garay SM, et al. Pulmonary complications of the acquired immunodeficiency syndrome. Report of a Nation Heart, Lung, and Blood Institute workshop. N Engl J Med 1984; 310: 1682-8.

29. Schein MH, Fischl MA, Pitchenik AE, et al. ICU survival of patients with the acquired immunodeficiency syndrome. Crit Care Med 1986; 14: 1026-7.

30. Friedman Y, Franklin C, Rackow EC, et al. Improved survival in patients with AIDS, Pneumocystis carinii pneumonia, and severe respiratory failure. Chest 1989; 96: 862-6.

31. Palella FJ, Delaney KM, Moorman AC, et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. N Engl J Med 1998; 338: 853-860.

32. Petrucci N, Ivacovelli W. Ventilation with lower tidal volumes versus traditional tidal volumes in adults for acute lung injury and acute respiratory distress syndrome. Cochrane Database Syst Rev 2003; (3): CD003844.

33. Hickling KG, Walsh J, Henderson S, et al. Low mortality rate in adult respiratory distress syndrome using low-volume, pressure-limited ventilation with permissive hypercapnia: a prospective study. Crit Care Med 1994; 22: 1568-78.

34. Rosenberg AL, Seneff MG, Atiyeh L, et al. The importance of bacterial sepsis in intensive care unit patients with acquired immunodeficiency syndrome: Implications for future care in the age of increasing antiretroviral resistance. Crit Care Med 2001; 29: 548-56.

35. Morris A, Masur H, Huang L. Current issues in critical care of the human immunodeficiency virus-infected patient. Crit Care Med 2006; 34: 239-240.

36. Hirschtick R, Glassroth J, Jordan M, et al. Bacterial pneumonia in persons infected with the human immunodeficiency virus. N Engl J Med 1995; 333: 845-51.

37. Vega-Barrientos RS, Reyes-Terán G. Complicaciones infecciosas pulmonares en los pacientes infectados por el VIH. Neumología y Cirugía de Tórax 2005; 64(2): 48-62.

38. Petrosillo N, Nicastri E, Viale P. Nosocomial pulmonary infections in HIV-positive patients. Curr Opin Pulm Med 2005; 11: 231-5.

39. Franzetti F, Grassini A, Piazza M, et al. Nosocomial bacterial pneumonia in HIV-infected patients: risk factors for adverse outcome and implications for rational empiric antibiotic therapy. Infection 2006; 34: 9-16.

40. Yeni PG, Hammer SM, Carpenter CC, et al. Antiretroviral treatment for adult HIV infection in 2002: update recommendations of the International AIDS Society-USA Panel. JAMA 2002; 288: 222-35.

41. Carr A, Cooper DA. Adverse effects of antiretroviral therapy. Lancet 2000; 356: 1423-30.

42. Lawn SD, Bekker LG, Miller RF. Immune reconstitution disease associated with mycobacterial infections in HIV infected individuals receiving antiretrovirals. Lancet Infect Dis 2005; 5: 361-73.

43. Hirsch HH, Kaufmann G, Sendi P, Battegay M. Immune reconstitution in HIV infected patients. Clin Infect Dis 2004; 38: 1159-66.

44. SJ Dickson, S Batson, AJ Copas, SG Edwards, M Singer, RF Miller. Survival of HIV-infected patients in the intensive care unit in the era of highly active antiretroviral therapy. Thorax 2007; 62: 964-8.

45. Morris A, Wachter RM, Luce J, Turner J, Huang L. Improved survival with highly active antiretroviral therapy in HIV-infected patients with severe Pneumocystis carinii pneumonia. AIDS. 2003; 17(1): 73-80.

46. Benfield TL, Helweg-Larsen J, Bang D, Junge J, Lundgren JD. Prognostic markers of short-term mortality in AIDS-associated Pneumocystis carinii pneumonia. Chest 2001; 119: 844-51.

47. Kales CP, Murren JR, Torres RA, Crocco JA. Early predictors of in-hospital mortality for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. Arch Intern Med 1987; 147: 1413-17.

48. Forrest DM, Zala C, Djurdjev O, et al. Determinants of short- and long-term outcome in patients with respiratory failure caused by AIDS-related Pneumocystis carinii pneumonia. Arch Intern Med 1999; 159: 741-47.

49. Bédos JP, Dumoulin JL, Gachot B, Veber B, Wolff M, Régnier B, Chevret S. Pneumocystis carinii pneumonia requiring intensive care management: survival and prognostic study in 110 patients with human immunodeficiency virus. Crit Care Med 1999; 27: 1109-1115.