Modern death risk factors in patients with community-acquired pneumonia

Povalyaeva, L.; Бородулин, Б. Е.; Бородулина, Е. А.; Chernogaeva, G. Yu.; Chumanova, E.S.

doi:10.17816/kmj1718

Cited by 4 publications

(2 citation statements)

References 3 publications

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“…In the first hours of admission of a patient with ARF to the ICU, the issue of selecting a respiratory support method is urgent. Pulse oximetry indices (SрО 2 ) and general condition of the patient are commonly the main indicators for the selection [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…Given the fact that the main physical disorders indicating the severity of the patient's condition are determined by changes in the respiratory metabolism in case of ARF developing due to severe communityacquired pneumonia, we considered it appropriate to look at the values of the patients' arterial blood acid-base balance (ABB) and gas composition as indications for selection of respiratory support methods on admission to ICU [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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A New Approach to the Selection of Respiratory Support Methods in Pulmonology

Borodulina¹,

Chernogaeva²,

Povalyaeva³

et al. 2018

Sovrem Tehnol Med

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The aim of the study was to evaluate the efficacy of the new approach to the selection of respiratory support methods based on the analysis of arterial blood acid-base balance and gas composition in treatment of severe community-acquired pneumonia complicated by acute respiratory failure.Materials and Methods. Conventional pulse oximetry (SрО 2 ) was used (G40 Patient Monitor), arterial blood acid-base balance and gas composition were analyzed (EasyStat device) to detect hypoxemia. Respiratory support of three types was carried out: 1) oxygen therapy (О 2 -therapy) with the use of oral nasal oxygen masks; 2) non-invasive lung ventilation (VENTIlogic 2 and BiPAP Vision devices); 3) artificial lung ventilation (Engström Carestation device).The work was carried out in two sequential stages. At the first stage, a respiratory support method was selected according to the results of pulse oximetry (SрО 2 ). At the second stage, a respiratory support method was selected on the basis of arterial blood acid-base balance and gas composition indices (рО 2 , pH, рCО 2 ). Recovery of pulse oximetry indices, arterial blood acid-base balance, and gas composition indices as well as presence of positive clinical dynamics were considered to be criteria of treatment efficacy.Results. Comparative analysis of the results of the used methods has provided the possibility to develop the algorithm of choosing the respiratory support method in severe community-acquired pneumonia on the basis of arterial blood acid-base balance and gas composition with pulse oximetry indices equalling 91.0±0.8%. On admission of a patient to the intensive care unit, oxygen therapy is administered at рН≥7.3; рO 2 >60 mm Hg; рСО 2 ≤45 mm Hg; non-invasive lung ventilation -at pH<7.3; рO 2 ≤60 mm Hg; рСО 2 ≤45 mm Hg; artificial lung ventilation -at pH<7.3; рO 2 <60 mm Hg; рСО 2 >45 mm Hg. Selection of respiratory support based on blood acid-base balance and gas composition indices without taking into account pulse oximetry indices allows us to increase treatment efficacy, reduce the period of stay in the intensive care unit by 1.5 times, mortality -by 4.3 times.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A New Approach to the Selection of Respiratory Support Methods in Pulmonology

Borodulina¹,

Chernogaeva²,

Povalyaeva³

et al. 2018

Sovrem Tehnol Med

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Optimization of choice of respiratory support the intensive care severe community-acquired pneumonia.

et al. 2018

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The purpose of study is the optimization of the choice of method of respiratory support in patients with severe community-acquired pneumonia (CAP) on admission to intensive care unit (ICU) on the basis of acid-alkaline indicators and arterial blood gas analysis. Material and methods. Depending on the method of the choice of respiratory support two groups of 350 people were formed. The first group (n = 350) - by the results of pulse oximetry (SatO2). The second group (n = 350) - in terms of acid-base and arterial blood gas analysis (pH, PO2, PCO2). To determine hypoxemia, pulse oximetry (heart monitor GOLDWAY G40), acid-alkali and gas composition of arterial blood (gas analyzer «MEDICA EasyStat») were used. In the ICU there were conducted three types of respiratory support: 1) oxygen therapy via orinasal mask 2) non-invasive mechanical ventilation (respirators «VENTimotion 2» and «Bipap Vision») 3) mechanical ventilation («Engstrom Carestation»). The criterion of effectiveness: recovery performance pulse oximetry, acid-base balance, and arterial blood gas analysis, the presence of positive clinical dynamics. Results. Choice of method of respiratory support in the gas composition of blood allowed to expand the indications for use NIV as a method of respiratory support in the treatment of patients with severe CAP, to ensure timely transfer and reduce the time finding patients on mechanical ventilation, to avoid damage due to hypoxia bodies - «target» with the development of multiple organ failure, and thus 4.3 times to reduce mortality and length of stay in the ICU of 1.7.

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The nosological structure of respiratory diseases in the pulmonology in-patient unit specifying the proportion of HIV positive patients

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Янина

et al. 2021

Tuberk. bolezni lëgk.

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The objective of the study: to identify respiratory diseases specifying the proportion of HIV-positive patients who have to be admitted to the pulmonology department of an emergency hospital.Subjects and methods. All cases admitted to the pulmonology department of Emergency Relief Hospital no. 2, Omsk, from 2016 to 2019 were analyzed.Results. Among patients admitted to the pulmonology department of the emergency hospital in 2016-2019, pneumonia was the most frequent nosology – from 51.6% (2017) to 63.2% (2019) followed by chronic obstructive lung disease – from 29.1% (2016) to 18.1% (2019). The average duration of hospital stay for pneumonia increased from 9.2 (2016) to 15.4 days (2019) that could be indicative of more severe cases due to the increased proportion of HIV positive patients from 22.4% (2016) to 49.1% (2019). Of pneumonia with the detected pathogen, cases of bacterial pneumonia were the most frequent, but in 2019 there was a significant (up to 19.3%) increase in pneumocystosis pneumonia. The frequency of lung cancer diagnostics ranged from 1.2% (2018) to 2.1% (2017 and 2019), which was associated with the low quality of early diagnosis and admission to hospital due to development of complications. The frequency of pulmonary tuberculosis detection in the pulmonology department tends to decrease every year – from 5.3% (2016) to 3.3% (2019), while the average duration of hospital stay before tuberculosis is diagnosed ranges from 4.9 ( 2016) to 5.9 days (2018). Among diagnosed tuberculosis patients, the proportion of HIV-positive people grows up every year – from 31.6% (2016) to 87.2% (2019).

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Modern death risk factors in patients with community-acquired pneumonia

Cited by 4 publications

References 3 publications

A New Approach to the Selection of Respiratory Support Methods in Pulmonology

A New Approach to the Selection of Respiratory Support Methods in Pulmonology

Optimization of choice of respiratory support the intensive care severe community-acquired pneumonia.

The nosological structure of respiratory diseases in the pulmonology in-patient unit specifying the proportion of HIV positive patients

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