Перейти к основному содержанию

SCIENTIFIC-PRACTICAL PEER-REVIEWED MONTHLY JOURNAL.
INSTITUTION OF MINISTRY OF PUBLIC HEALTH OF THE REPUBLIC OF BELARUS

INTENSIVE CARE OF PATIENTS WITH SEVERE COMMUNITY-ACQUIRED VIRAL AND BACTERIAL PNEUMONIA

Objective. Pathogenic justification and development of complex intensive care for the acute respiratory distress syndrome (ARDS) at patients with severe community-acquired viral and bacterial pneumonia.

Materials and methods. We analyzed the outcomes of treating 251 patients with severe community-acquired pneumonia complicated by the ARDS development and of 474 patients with community-acquired pneumonia, and 151 histopathological research protocols.

Results. Patients with severe community-acquired pneumonia and obesity (BMI > 30 kg/ m2), Sp02 < 95% need observation and treatment in an intensive care unit within 1—2 days. Falling of the cholesterol level lower than 3 mM/ l can serve as reliable predictive criterion of a critical condition development and a possible failure. The influenza virus A (H1N1) was identified in 25.9%, virus of parainfluenza type II — in 19%, adenovirus — in 2.4% of patients with ARDS. A longer replication period is characteristic for the influenza virus A (H1N1). Among the dead having stayed in hospital for 8 [6.0—9.0] days in the average the influenza virus A (H1N1) was identified in 86.8% of cases and for 20 [13.0—21.0] days — in 58% of cases. A. baumannii, P. aeruginosa, К. pneumoniae, S. aureus, Str. pyogenes prevailed among the microorganisms identified. Respiratory and nutritive supporting programs were developed for obese patients with ARDS.

Conclusion. The complex intensive care developed for patients with severe community-acquired viral and bacterial pneumonia complicated by the ARDS development allowed improve the therapy outcomes and lower mortality in this group of patients twice.