Дикий А. М., Сонник Э. Г., Шумейко А. Г.

ВЕНТИЛЯТОР-АСОЦИИРОВАНЫЕ ТРАХЕОБРОНХИТ И ПНЕВМОНИЯ


Об авторе:

Дикий А. М., Сонник Э. Г., Шумейко А. Г.

Рубрика:

ОБЗОРЫ ЛИТЕРАТУРЫ

Тип статьи:

Научная статья.

Аннотация:

Причины и патофизиологические механизмы инфекции нижних дыхательных путей при искусственной вентиляции лёгких (ИВЛ) ещё до конца не изучены. Большинство исследователей соглашается, что условием постановки диагноза вентилятор-асоциированый трахеобронхит (ВАТ) есть признаки инфекции, стойкое выделение мокроты из дыхательных путей, отсутствие инфльтративных теней на рентгенограме грудной клетки. Эти признаки воникают позже 48 часов после начала ИВЛ. Необходимость использования антибиотиков при данной патологии спорна. Большинство врачей считают целесообразным использование антибиотиков при ВАТ. Необходимы профилактические мероприятия. Вентилятор-асоциированая пневмония (ВАП) диагностируется, когда при наличии признаков ВАТ на рентгенограме появляются инфильтративные тени. С целью оптимального выбора антибиотика выделяют «раннюю» и «позднюю» нозокоминальную пневмонию. Рациональная терапия антибиотиками предполагает тактику де-скалации. По возможности необходимо ограничить нерациональное и чрезмерно длительное использование антибиотиков. В последнее время всё больше внимания придают возможностям ингаляционной терапии инфекции нижних дыхательных путей.

Ключевые слова:

искусственная вентиляция лёгких, вентилятор-асоциированый трахеобрнхит, вентилятор-асоциированая «рання» и «поздняя» пневмония, диагностика, антибиткорезистентность, лечение, профилактика, использование небулайзеров

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Публикация статьи:

«Вестник проблем биологии и медицины» Выпуск 3 (145), 2018 год, 22-29 страницы, код УДК 616.234-0022-02:615.8116.2

DOI: