Document 0336
 DOCN  M9460336
 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).