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M9460717.TXT
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1994-06-25
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Document 0717
DOCN M9460717
TI Sequential changes in vital signs and acid-base and blood-gas profiles
in Pneumocystis carinii pneumonitis in children with cancer. Basis for a
scoring system to identify patients who will require ventilatory
support.
DT 9408
AU Sanyal SK; Chebib FS; Gilbert JR; Hughes WT; Department of Pediatrics,
King Faisal University, Dammam, Saudi; Arabia.
SO Am J Respir Crit Care Med. 1994 May;149(5):1092-8. Unique Identifier :
AIDSLINE MED/94228045
AB Early reliable identification of patients with Pneumocystis carinii
pneumonia (PCP) who will require ventilatory support would be desirable.
To develop a predictive system to meet this need, we studied,
prospectively, the sequential alterations in vital signs and acid-base
and blood-gas profiles associated with this disease in 55 children with
cancer, 29 of whom did not require ventilatory support (Group I) and 26
who did (Group II). None of the patients had acquired immunodeficiency
syndrome (AIDS). On admission to the hospital the only feature that
distinguished patients in Group I from those in Group II was the mean
(+/- SD) respiratory rate (38.7 +/- 2.1 versus 49.1 +/- 3.5 breaths/min,
p < 0.02). By 12 h after admission there was a significant difference in
the partial pressure of oxygen (PaO2) between Groups I and II (75.1 +/-
3.2 mg Hg versus 65.4 +/- 3.1 mm Hg, p < 0.05), and also in the two
groups' inspired fraction of oxygen (FIO2; 24.9 +/- 0.54% versus 29.6
+/- 1.6%, p < 0.01). Both alterations, as well as tachypnea, persisted
for the remainder of the study period. The maximum FIO2 did not exceed
45% in Group I, and by 60 h after admission to the hospital, all
patients in this group had persistent increases in PaO2 that exceeded 80
mm Hg, permitting decreases in FIO2 to that of room air. In Group II,
hypoxemia was refractory despite an increase in FIO2 to 50%, at which
point ventilatory support was begun (at a mean of 81.1 +/- 32.3 h after
admission).(ABSTRACT TRUNCATED AT 250 WORDS)
DE Acid-Base Equilibrium Adolescence Body Temperature Carbon
Dioxide/BLOOD Child Child, Preschool Female Heart Rate Human
Immunocompromised Host Infant Male
Neoplasms/*COMPLICATIONS/IMMUNOLOGY Oxygen/BLOOD Pneumonia,
Pneumocystis carinii/BLOOD/COMPLICATIONS/ *PHYSIOPATHOLOGY/THERAPY
Prospective Studies Respiration *Respiration, Artificial Risk Factors
Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).