CLINICAL AND IMMUNOLOGICAL CHARACTERISTICS OF COMMUNITY-ACQUIRED PNEUMONIA IN CHILDREN WITH HEART FAILURE AND OPTIMIZATION OF REHABILITATION METHODS

Ismatullaev Sohibjon Kudratovich

Termez branch of the Tashkent Medical Academy Propaedeutics of childhood diseases, assistant of the Department of Pediatrics in childhood diseases and family medicine

Keywords: community-acquired infections, pneumonia, antibacterial drugs, respiratory therapy.


Abstract

The purpose of the updated clinical recommendations is to provide specialists, primarily anesthesiologists and resuscitators, with modern, evidence-based medicine data on the etiology, epidemiology, methods of diagnosis, treatment and prevention of severe community-acquired pneumonia in adults. In preparing this document, high-level scientific studies, systematic reviews and meta-analyses, recommendations of the Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS), European Respiratory Society/European Society of Intensive Care Medicine/European Society of Clinical Microbiology and Infectious Diseases/ Latin American Thoracic Society (ERS/ESICM/ESCMID/ALAT) and other leading professional societies.  Modern recommendations for differentiated antibiotic therapy for patients with severe community-acquired pneumonia (CAP), depending on the presence of risk factors for infection with certain microorganisms, are presented in detail, and etiotropic therapy regimens for the identified pathogen are presented. A significant section of the recommendations is devoted to respiratory therapy for TVP; a stepwise algorithm for the treatment of acute respiratory failure is formulated depending on its stage. The most effective and safe modes of invasive and non-invasive methods of respiratory support are characterized in detail. Glucocorticosteroids are named as methods of adjuvant therapy if it is impossible to stabilize hemodynamic parameters against the background of adequate hydration and vasopressor support, as well as parenteral anticoagulants to prevent thromboembolic complications. Anti-pneumococcal and anti-influenza vaccines have been proposed to prevent TVP in high-risk patients. Criteria for assessing the quality of medical care are presented...


References

Geppe NA, Volkov IK. Perspektivy razvitija i problemy detskoj pul'monologii v Rossii [Development prospects and challenges of pediatric pulmonology in Russia] Pul'monologija. 2007;4:5-6. Russian.

Grigor'ev KI. Sovremennyj vzgljad na pnevmoniju u detej i podhody k ee lecheniju i profilaktike [Modern view on pneumonia at children and approaches to its treatment and prophylaxis] Medicinskaja pomoshh'. 2005;2:3-9. Russian.

Еvdokimova DV, Уlanova AV. Issledovanie osobennostej vnebolnichnoj pnevmonii u detej i podrostkov [Research of features of community-acquired pneumonia at children and teenagers] Materialy 52-j ezhegodnoj vserossijskoj konferencii studentov i molodyx uchenyx «aktualnye problemy teoreticheskoj, eksperimentalnoj, klinicheskoj mediciny i farmacii», posvyashhennoj 90-letiyu doktora medicinskix nauk, professora, zasluzhennogo deyatelya nauki rf pavla vasilevicha dunaeva (g. Tyumen, 12 aprelya 2018 g.). Tyumen: ric «ajveks»; 2018:304.

Zakirov II, Safina AI. Kriterii diagnostiki i lechenija vnebol'nichnoj pnevmonii u detej [Criteria for diagnosis and treatment of community-acquired pneumonia in children] Prakticheskaja medicina. 2012;7:32-7. Russian.

Ostrye respiratornye zabolevanija u detej: lechenie i profilaktika. Nauchno-prakticheskaja programma Sojuza pediatrov Rossii. [Acute respiratory diseases at children: treatment and prevention. Scientific and practical program of the Union of pediatricians of Russia] Moscow: Mezhdunarodnyj Fond ohrany zdorov'ja materi i rebenka, 2002. Russian.

Protokol Minzdrava Rossii ot 28 dekabrja 2012 g. Protokoly lechenija vnebol'nichnoj pnevmonii u detej [The protocol of the Russian Ministry of Health of December 28, 2012. Protocols of treatment of communityacquired pneumonia at children] Oficial'nyj sajt Minzdrava Rossii. Available from: www.rosminzdrav.ru (accessed 28 December 2012).

Pivchenko P.G., Pivchenko T.P. Comparative analysis of the development of the pancreas in humans and white rats in the embryonic period (substantiation of the experimental model). Original scientific publications. 2016: 80–3.

Kaligin M.S., Titova A.A., Plyushkina A.S., Titova M.A., Gumerova A.A., Kiyasov A.P. Proliferation of pancreatic cells in experimental diabetes. Genes & cells. 2014, Volume 4, 3: 85–8.