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

Abstract

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.