Patients with human immunodeficienc

Patients with human immunodeficiency virus infection presenting with an acute severe respiratory failure should be considered. The CD4 cell count helps to predict outcome, but this is not absolute. However, patients with acquired immunodeficiency disease (AIDS; stage 4 of the disease)will most likely not have the immune reserve to control the pathological process. Many lung diseases are not reversible, including lung fibrosis, emphysema, cystic fibrosis and chronic obstructive oulmonary disease. However, an acute infection may just be recoverable with the possibility that the patients condition will return to baseline or slightly worsen after ECMO support .The clinician will have to assess the impact of 'slightly worse and weigh up the probability of a good outcome versus failure to recover .