title: The potential anesthetic threats, challenges and intensive care considerations in patients with HIV infection.
abstract: Acquired immunodeficiency syndrome (AIDS) has become a pandemic with ever looming danger of its transmission in health professionals. The number of AIDS patients has increased tremendously over the last two decades, who present for surgical procedures as well as who get admitted in intensive care unit for their critical condition. As such anesthesiologists and intensivists are exposed to potential risk of disease transmission on a daily basis from such patients. The guidelines and protocols formulated in the western world regarding prevention of disease transmission cannot be applied uniformly in the developing nations, such as India due to various factors and limitations. As such there is a continuous need felt in this arena to prevent the catastrophic consequences of AIDS in our medical fraternity while treating such patients in operation theatres and critical care units. This study reviews the various pathophysiological aspects, anesthetic considerations, intensive care implications, and various areas where current knowledge about AIDS can be applied to prevent its potential transmission in high-risk clinical groups.
authors.affiliation: Department of Anaesthesiology and Intensive Care, Gian Sagar Medical College and Hospital, Ram Nagar, Banur, Punjab, India.
authors.forename: Sukhminder Jit Singh
authors.initials: SJ
authors.lastname: Bajwa
authors.forename: Ashish
authors.initials: A
authors.lastname: Kulshrestha
keywords: Acquired immunodeficiency syndrome; anesthesia; anti-retroviral therapy; human immunodeficiency virus; intensive care
references.citation: Thorax. 2001 Dec;56 Suppl 4:IV1-64
references.pmid: 11713364
references.citation: Anaesthesist. 2003 Dec;52(12):1124-31
references.pmid: 14691624
references.citation: Coll Antropol. 2006 Dec;30 Suppl 2:3-10
references.pmid: 17508467
references.citation: Science. 1983 May 20;220(4599):868-71
references.pmid: 6189183
references.citation: N Engl J Med. 1999 Apr 1;340(13):977-87
references.pmid: 10099139
references.citation: J Infect Dis. 1993 Jul;168(1):68-74
references.pmid: 8515134
references.citation: Am J Respir Crit Care Med. 2002 Aug 1;166(3):262-7
references.pmid: 12153955
references.citation: J Clin Anesth. 2003 May;15(3):224-33
references.pmid: 12770662
references.citation: Anesth Analg. 2004 Feb;98(2):503-511
references.pmid: 14742395
references.citation: AIDS. 2004 Jul 2;18(10):1429-33
references.pmid: 15199319
references.citation: Can Fam Physician. 1997 Aug;43:1376-81
references.pmid: 9266122
references.citation: Anesthesiology. 1995 Jan;82(1):32-7
references.pmid: 7832326
references.citation: JAMA. 1998 Jul 1;280(1):55-60
references.pmid: 9660364
references.citation: Obstet Gynecol. 1999 Dec;94(6):942-7
references.pmid: 10576180
references.citation: Anaesthesist. 2000 Dec;49(12):1006-17
references.pmid: 11202073
references.citation: Anesthesiology. 2002 Aug;97(2):320-4
references.pmid: 12151919
references.citation: Proc Am Thorac Soc. 2006;3(1):96-102
references.pmid: 16493156
references.citation: Int J Obstet Anesth. 2000 Apr;9(2):99-124
references.pmid: 15321097
references.citation: BMJ. 2001 Jun 9;322(7299):1410-2
references.pmid: 11397751
references.citation: Crit Rev Neurobiol. 1990;5(4):313-62
references.pmid: 2204485
references.citation: JAMA. 1989 May 26;261(20):2997-3006
references.pmid: 2654428
references.citation: Transfusion. 1996 Oct;36(10):860-5
references.pmid: 8863771
references.citation: Curr Opin Anaesthesiol. 2009 Jun;22(3):412-8
references.pmid: 19434795
references.citation: Infect Dis Clin North Am. 2007 Mar;21(1):103-32, ix
references.pmid: 17502232
references.citation: N Engl J Med. 1981 Dec 10;305(24):1425-31
references.pmid: 6272109
references.citation: Mt Sinai J Med. 2002 Oct;69(5):329-33
references.pmid: 12415327
references.citation: Anaesthesia. 2000 Apr;55(4):344-54
references.pmid: 10781120
references.citation: MMWR Recomm Rep. 2005 Sep 30;54(RR-9):1-17
references.pmid: 16195697
references.citation: Lancet. 1999 Mar 27;353(9158):1035-9
references.pmid: 10199349
references.citation: AIDS. 2008 Sep;22 Suppl 3:S1-6
references.pmid: 18845916
references.citation: J Burn Care Rehabil. 1987 Nov-Dec;8(6):483-7
references.pmid: 3325509
references.citation: Crit Care. 2005;9(6):R623-30
references.pmid: 16280060
references.citation: Yonsei Med J. 2004 Feb 29;45(1):1-6
references.pmid: 15004861
references.citation: J Anesth. 2008;22(3):263-77
references.pmid: 18685933
references.citation: MMWR Morb Mortal Wkly Rep. 1988 Jun 24;37(24):377-82, 387-8
references.pmid: 2836717