Key result
Cardiopulmonary bypass during emergency valve replacement may accelerate underlying infections in HIV endocarditis.
Why the study?
Does cardiopulmonary bypass accelerate underlying infections in HIV-risk intravenous drug abusers undergoing emergency valve replacement for left-sided endocarditis?
Case Report (n=2)
Does cardiopulmonary bypass accelerate underlying infections in HIV-risk intravenous drug abusers undergoing emergency valve replacement for left-sided endocarditis?
Cardiopulmonary bypass during emergency valve replacement may accelerate underlying HIV infection in intravenous drug abusers with endocarditis, suggesting a nonoperative approach might be justified in this high-risk group.
Answers are grounded in this paper and cite their sources.
May warrant caution with cardiopulmonary bypass in HIV endocarditis; hypothesis-generating from Level 5 evidence and leaves open need for prospective data.
Emergency valve replacement for left-sided endocarditis in intravenous drug abusers with a poor long-term prognosis makes the operative decision a difficult one, especially when they are also at risk for HIV infection. The influence of cardiopulmonary bypass on 2 patients may have accelerated the clinical manifes tations of their underlying infections, including a marked acceleration and death in one. These cases suggest that cardiopulmonary bypass perturbs the immune system. The safety of cardiopulmonary bypass in these settings is questioned and a nonoperative approach may be justified in this high-risk group of endocarditis patients.
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Edward S. Yee (1991) conducted a case report in HIV Endocarditis (n=2). Cardiopulmonary bypass was evaluated on Acceleration of clinical manifestations of underlying infections. Cardiopulmonary bypass during emergency valve replacement in 2 patients with HIV endocarditis may have accelerated underlying infections, resulting in death in one patient.
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