Session/Time	Pulmonary I/Thu, 9:45 - 12 00 PM
Title	Respiratory Failure in Human Immunodeficiency Virus (HIV) Disease --Do Steroid Help?
Author	D King, MD; EE Conway, Jr., MD
Affiliation	Pediatric Critical Care Department, Albert Einstein College of Medicine, Bronx, N. Y and Beth Israel Medical Center, New York, N.Y.
Introduction	This retrospective study examined the relationship between steroid use and outcome from respiratory failure (RF) due to PCP in patients with HIV disease.
Method	Charts of patients with HIV disease who were admitted to the Pediatric Critical Care Unit (PCCU) from January' 1, 1986 to December 31, 1995 for RF were reviewed. - Outcome variables studied were survival, days of mechanical ventilation and PCCU length of stay. Survival was analyzed by Chi-square and ANOVA was used to compare continuous data. P value <.05 was considered significant. <.05 was considered significant. Results: There were 66 admissions for RF and 35 had Pneumocystis carinii pneumonia (PCP); 57% of these patients received steroids (S). Patients with PCP who received steroids had significantly better survival, patients with bacterial or viral infections who received steroids did not have any increase in mortality (see table below). Steroids did not shorten the course of mechanical ventilation (PCP plus S 11.4 +/-4 days vs. PCP minus S 15.5 +/-9 days; p=".07)" or PCCU length of stay (PCP plus S 13.8 +/-6 days vs. PCP minus S 15.2 +/-10 days; p=".58)."
Result	There wer 66 admissions for RF and 35 had Pneumocystis carinii pneumonia (PCP); 57% of these patients reeived steroids(S). Patients with PCP who received steroids had significantly better survival; patients with bacterial or viral infections who received steroids did not have any increase in mortality(see table below) Steroids did not shorten the course of mechanical ventilation (PCP plus S 11.4 +/-4 days vs. PCP minus S 15.5 +/-9 days; p =.07) or PCCU length of stay (PCP plus S 13.8 +/-6 days vs. PCP minus S 15.2 +/-10 da s; p =.58).
Conclusion	The use of steroids has sic,nificantly improved survival from PCP, buthas not shortened ilic duration of illness (length of f time on a ventilator or length of stay in the PCCU). Steroid use in patients with bacterial or viral infections docs not increase mortality.

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