title: Etiologies, clinical features and outcome of cardiac arrest in HIV-infected patients.
abstract: BACKGROUND
  Compared to many other cardiovascular diseases, there is a paucity of data on the characteristics of successfully resuscitated cardiac arrest (CA) patients with human immunodeficiency virus (HIV) infection. We investigated causes, clinical features and outcome of these patients, and assessed the specific burden of HIV on outcome.
  
  
  METHODS
  Retrospective analysis of HIV-infected patients admitted to 20 French ICUs for successfully resuscitated CA (2000-2012). Characteristics and outcome of HIV-infected patients were compared to those of a large cohort of HIV-uninfected patients admitted after CA in the Cochin Hospital ICU during the same period.
  
  
  RESULTS
  99 patients were included (median CD4 lymphocyte count 233/mm(3), viral load 43 copies/ml). When compared with the control cohort of 1701 patients, HIV-infected patients were younger, with a predominance of male, a majority of in-hospital CA (52%), and non-shockable initial rhythm (80.8%). CA was mostly related to respiratory cause (n=36, including 23 pneumonia), cardiac cause (n=33, including 16 acute myocardial infarction), neurologic cause (n=8) and toxic cause (n=5). CA was deemed directly related to HIV infection in 18 cases. Seventy-one patients died in the ICU, mostly for care withdrawal after post-anoxic encephalopathy. After propensity score matching, ICU mortality was not significantly affected by HIV infection. Similarly, HIV disease characteristics had no impact on ICU outcome.
  
  
  CONCLUSIONS
  Etiologies of CA in HIV-infected patients are miscellaneous and mostly not related to HIV infection. Outcome remains bleak but is similar to outcome of HIV-negative patients.
authors: Medical Intensive Care Unit, Cochin University Hospital, Groupe Hospitalier Paris Centre, Assistance Publique - Hôpitaux de Paris, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
authors: Nicolas
authors: N
authors: Mongardon
authors: Medical Intensive Care Unit, Cochin University Hospital, Groupe Hospitalier Paris Centre, Assistance Publique - Hôpitaux de Paris, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; INSERM U970, Sudden Death Expertise Centre, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, France.
authors: Guillaume
authors: G
authors: Geri
authors: Medical Intensive Care Unit, Lariboisière University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.
authors: Nicolas
authors: N
authors: Deye
authors: Medical Intensive Care Unit, Bichat University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.
authors: Romain
authors: R
authors: Sonneville
authors: Medical Intensive Care Unit, Henri Mondor University Hospital, Assistance Publique - Hôpitaux de Paris, Créteil, France; Medical Intensive Care Unit, Georges Pompidou European University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.
authors: Florence
authors: F
authors: Boissier
authors: Intensive Care Unit, Clermont-Ferrand University Hospital, Clermont-Ferrand, France.
authors: Sébastien
authors: S
authors: Perbet
authors: Medical Intensive Care Unit, Bicêtre University Hospital, Assistance Publique - Hôpitaux de Paris, Le Kremlin-Bicêtre, France.
authors: Laurent
authors: L
authors: Camous
authors: Medical Intensive Care Unit, Saint Louis University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.
authors: Virginie
authors: V
authors: Lemiale
authors: Intensive Care Unit, Victor Dupouy Hospital, Argenteuil, France.
authors: Marina
authors: M
authors: Thirion
authors: Intensive Care Unit, La Source Hospital, Orléans, France.
authors: Armelle
authors: A
authors: Mathonnet
authors: Intensive Care Unit, Edouard Herriot University Hospital, Hospices Civils de Lyon, Lyon, France.
authors: Laurent
authors: L
authors: Argaud
authors: Intensive Care Unit, Ambroise Paré University Hospital, Assistance Publique - Hôpitaux de Paris, Boulogne-Billancourt, France.
authors: Laurent
authors: L
authors: Bodson
authors: Medical Intensive Care Unit, Louis Mourier University Hospital, Assistance Publique - Hôpitaux de Paris, Colombes, France.
authors: Stéphane
authors: S
authors: Gaudry
authors: Medical Intensive Care Unit, Nancy-Brabois University Hospital, Nancy, France.
authors: Antoine
authors: A
authors: Kimmoun
authors: Intensive Care Unit, André Mignot Hospital, Versailles, France.
authors: Stéphane
authors: S
authors: Legriel
authors: Medical Intensive Care Unit, Angers University Hospital, Angers, France.
authors: Nicolas
authors: N
authors: Lerolle
authors: Intensive Care Unit, Raymond Poincaré University Hospital, Assistance Publique - Hôpitaux de Paris, Garches, France.
authors: David
authors: D
authors: Luis
authors: Medical Intensive Care Unit, Pitié-Salpétrière University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.
authors: Charles-Edouard
authors: CE
authors: Luyt
authors: Pulmonary Medicine and Medical Intensive Care Unit, Pitié-Salpétrière University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.
authors: Julien
authors: J
authors: Mayaux
authors: Medical Intensive Care Unit, Saint-Antoine University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.
authors: Bertrand
authors: B
authors: Guidet
authors: Medical Intensive Care Unit, Cochin University Hospital, Groupe Hospitalier Paris Centre, Assistance Publique - Hôpitaux de Paris, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
authors: Frédéric
authors: F
authors: Pène
authors: Medical Intensive Care Unit, Cochin University Hospital, Groupe Hospitalier Paris Centre, Assistance Publique - Hôpitaux de Paris, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
authors: Jean-Paul
authors: JP
authors: Mira
authors: Medical Intensive Care Unit, Cochin University Hospital, Groupe Hospitalier Paris Centre, Assistance Publique - Hôpitaux de Paris, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; INSERM U970, Sudden Death Expertise Centre, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, France. Electronic address: alain.cariou@cch.aphp.fr.
authors: Alain
authors: A
authors: Cariou
mesh_terms: D000328:Adult; D000368:Aged; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology*; D006323:Heart Arrest / Q000175:diagnosis / Q000276:immunology / Q000821:virology*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D019562:Viral Load
keywords: Aids; Cardiac arrest; Human immunodeficiency virus; Immunodepression; Prognosis; Sudden death