Outcomes of non-invasive ventilation HIV positive patients with Sepsis and respiratory failure presenting to the adult medical emergency unit of the University Teaching Hospital, Lusaka, Zambia
type: CreativeWork
description: Background: Method: Results: Conclusion Sepsis due to respiratory disease is one of the main complications of HIV/AIDS. Audit data from the Department of Internal Medicine at the University Teaching Hospital in Lusaka, Zambia indicate that pneumonia and tuberculosis in HIV represent two of the four leading causes of death. The mortality rate has remained high despite the advances made in antimicrobial spectrum. Limited ventilatory support options for patients with respiratory complications contribute to the high mortality rate. It is envisaged that non-invasive ventilation (NIV) will help reduce the mortality rate in this patient sub-population. Since Zambia has limited ICU capacity, less complex interventions such as NIV, might be lifesaving. We conducted an observational prospective cohort study for the NIV arm (in the first half of 2016) with a retrospective chart review for the controls that focused on HIV positive patients with sepsis and hypoxaemic respiratory failure. 77 consecutive HIV positive patients with sepsis and respiratory distress meeting the inclusion criteria constituted the study population. Using the same clinical criteria 77 historical comparator patients were added from available charts reviewed from January 2014 to January 2016. After initial review of 385 folders, every 5th file was selected as comparator group. All patients meeting the inclusion criteria were offered NIV unless they opted out or refused to give consent. Clinical details were obtained and NIV initiated and clinical follow up recorded at 1, 24, 48 hours and daily assessment for 72 hours. Primary outcomes were patient tolerability on NIV. Secondary outcomes were survival to hospital discharge of participants on NIV. Clinical outcomes from the NIV arm were compared with the historical group. 18 out of 77 patients receiving NIV (23.3%) died and the rest had a hospital survival to discharge. One patient in the NIV group left against medical advice after 48 hours, but his 24 and 4…
abstract: Background: Method: Results: Conclusion Sepsis due to respiratory disease is one of the main complications of HIV/AIDS. Audit data from the Department of Internal Medicine at the University Teaching Hospital in Lusaka, Zambia indicate that pneumonia and tuberculosis in HIV represent two of the four leading causes of death. The mortality rate has remained high despite the advances made in antimicrobial spectrum. Limited ventilatory support options for patients with respiratory complications contribute to the high mortality rate. It is envisaged that non-invasive ventilation (NIV) will help reduce the mortality rate in this patient sub-population. Since Zambia has limited ICU capacity, less complex interventions such as NIV, might be lifesaving. We conducted an observational prospective cohort study for the NIV arm (in the first half of 2016) with a retrospective chart review for the controls that focused on HIV positive patients with sepsis and hypoxaemic respiratory failure. 77 consecutive HIV positive patients with sepsis and respiratory distress meeting the inclusion criteria constituted the study population. Using the same clinical criteria 77 historical comparator patients were added from available charts reviewed from January 2014 to January 2016. After initial review of 385 folders, every 5th file was selected as comparator group. All patients meeting the inclusion criteria were offered NIV unless they opted out or refused to give consent. Clinical details were obtained and NIV initiated and clinical follow up recorded at 1, 24, 48 hours and daily assessment for 72 hours. Primary outcomes were patient tolerability on NIV. Secondary outcomes were survival to hospital discharge of participants on NIV. Clinical outcomes from the NIV arm were compared with the historical group. 18 out of 77 patients receiving NIV (23.3%) died and the rest had a hospital survival to discharge. One patient in the NIV group left against medical advice after 48 hours, but his 24 and 4…
author: Mwiinga, Linos
language: en
keywords: HIV/AIDS Disease-Lusaka, Zambia, Respiratory, Artificial-Methods, Respiratory Therapy-Lusaka, Zambia, Artificial Respiration-Equipment and Supplies-Zambia
date published: 2016
date modified: 2026-07-27T22:05:56Z
provider: University of Zambia
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: University of Zambia