title: Outcome of tuberculous meningitis patients requiring mechanical ventilation.
abstract: OBJECTIVE
  There is paucity of information about the outcome of tuberculous meningitis (TBM) patients on mechanical ventilation (MV). In this communication, we report the clinical characteristics, predictors of MV, and outcome of TBM patients requiring MV.
  
  
  METHODS
  Thirty-eight (18%) of 205 patients with TBM requiring MV were included; and their demographic, clinical, cerebrospinal fluid, and magnetic resonance imaging finding at admission and follow-up were noted. The ventilator-related and systemic complications, hospital death, and 3-month functional outcome were noted. The predictors of need of MV were derived by multivariate regression analysis.
  
  
  RESULTS
  There were 38 MV and 36 non-MV TBM patients who were matched for age, sex, and stage of meningitis on admission. The requirement of MV was independently related to leukocytosis, seizure, and cerebrospinal fluid pleocytosis on admission. Patients on MV had higher frequency of septicemia (9 vs 2), bedsores (6 vs 0), and gastric hemorrhage (4 vs 0) compared with non-MV patients. Only 29% of MV patients survived and had poor outcome at 3 months; but in the non-MV group, all the patients survived, and only 11% had poor outcome.
  
  
  CONCLUSIONS
  Mechanical ventilation was needed in 18% TBM patients because of TBM-related or systemic complications. Those requiring MV had high mortality and may be categorized separately.
authors.affiliation: Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Science, Raebareily Rd, Lucknow.
authors.forename: U K
authors.initials: UK
authors.lastname: Misra
authors.affiliation: Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Science, Raebareily Rd, Lucknow. Electronic address: jayanteek@yahoo.com.
authors.forename: J
authors.initials: J
authors.lastname: Kalita
authors.affiliation: Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Science, Raebareily Rd, Lucknow.
authors.forename: S
authors.initials: S
authors.lastname: Betai
authors.affiliation: Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Science, Raebareily Rd, Lucknow.
authors.forename: S K
authors.initials: SK
authors.lastname: Bhoi
mesh_terms: D000328:Adult; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D012121:Respiration, Artificial / Q000009:adverse effects / Q000401:mortality; D014390:Tuberculosis, Meningeal / Q000134:cerebrospinal fluid / Q000150:complications / Q000401:mortality / Q000628:therapy*; D055815:Young Adult
keywords: Chronic meningitis; Intensive care unit; Mechanical ventilation; Mortality; Outcome; Tuberculous meningitis