CURRENT STATE AND PERSPECTIVE OF DIAGNOSTICS OF NOSOCOMIAL PNEUMONIA IN THOSE INJURED WITH MULTIPLE TRAUMA
https://doi.org/10.21292/2078-5658-2017-14-5-66-72
Abstract
Trauma injuries account for high mortality and disability in the cohort of the employable population. Pulmonary infectious complications in those injured with multiple traumas contribute the most to mortality of such patients. The article describes risk factors, causative agents, pathologic physiology and specific features of diagnostics of nosocomial pneumonia in those with multiple traumas. Special attention is paid to study of state and variants of the immune response to multiple trauma and related issues on using polymorphism of genes controlling the release of certain cytokines in order to improve diagnostics and prognosis of the course and outcome of nosocomial pneumonia in this group of patients.
About the Authors
A. V. Prokhorov
S. M. Kirov Military Medical Academy, St. Petersburg
Russian Federation
Pulmonologist, Post Graduate Student
Russian Federation
Pulmonologist, Post Graduate Student
Yu. Sh. Khalimov
S. M. Kirov Military Medical Academy, St. Petersburg
Russian Federation
Doctor of Medical Sciences, Professor, Head of Field Military Department
Russian Federation
Doctor of Medical Sciences, Professor, Head of Field Military Department
S. V. Gayduk
S. M. Kirov Military Medical Academy, St. Petersburg
Russian Federation
Doctor of Medical Sciences, Associate Professor, Deputy Head of Field Military Department
Russian Federation
Doctor of Medical Sciences, Associate Professor, Deputy Head of Field Military Department
S. V. Gavrilin
S. M. Kirov Military Medical Academy, St. Petersburg
Russian Federation
Doctor of Medical Sciences, Professor
Russian Federation
Doctor of Medical Sciences, Professor
D. P. Meshakov
S. M. Kirov Military Medical Academy, St. Petersburg
Russian Federation
Doctor of Medical Sciences, Anesthesiologist and Emergency Physician
Russian Federation
Doctor of Medical Sciences, Anesthesiologist and Emergency Physician
A. I. Chepel
S. M. Kirov Military Medical Academy, St. Petersburg
Russian Federation
Doctor of Medical Sciences, Associate Professor
Russian Federation
Doctor of Medical Sciences, Associate Professor
References
1. Baygozina E.А., Sovalkin V.I. Functional polymorphism of genes of regulatory molecules and cytokines in nosocomial pneumonia. Pulmonoloiya, 2008, no. 1, pp. 116-120. (In Russ.)
2. Gavrilin S.V., Boyarintsev V.V., Suborova T.N. et al. Osobennosti ranney profilaktiki vnutribolnichnoj pnevmonii v statsionare po lecheniyu tyazhelykh raneniy travm. Sovremennye sredstva immunodiagnostiki i immunoehkstrennoy profilaktiki aktualnykh infektsiy. [Specific prevention of nosocomial infection in in-patient unit for treatment of severe wounds and trauma. Modern tools of immune diagnostics and immune emergency prevention of actual infections]. St. Petersburg, Voenno-Meditsinskaya Akademiya Publ., 2004, pp. 75-77.
3. Gavrilin S.V., Kuzin А.А., Boyarintsev V.V. et al. Osobennosti epidemicheskogo protsessa gospitalnykh infektsiy v statsionare po lecheniyu tyazhelykh sochetannykh raneniy i travm. Sepsis: voprosy klinicheskoy patofiziologii, epidemiologii, diagnostiki i intensivnoy terapii. [Specific epidemics of nosocomial infection in the in-patient unit for treatment of severe concurrent wounds and traumas. Sepsis: clinical pathophysiology, epidemiology, diagnostics and intensive care]. Kemerovo, Kuzbassvuz-Izdat Publ., 2006, pp. 68-75.
4. Gavrilin S.V., Lebedev V.F. Otsenka effektivnosti interleykina 2 v kompleksnoy intensivnoy terapii tyazhelogo sepsisa. [Assessment of interleukin-2 efficiency in the comprehensive therapy of severe sepsis]. St. Petersburg, Novaya Alternativnaya Poligrafiya Publ., 2007, 51 p.
5. Gelfand B.R., Belotserkovskiy B.Z., Аlekseeva E.А. et al. Treatment of nosocomial pneumonia in surgical patients, VI Vserossiyskiy s"ezd anesteziologov
6. i reanimatologov. Yezisy. [VI All-Russian Conference of Anesthesiologists and Emergency Physicians. Abst. Book]. Moscow, 1998, 89 p.
7. Gumanenko E.K., Kozlov V.K., Gavrilin S.V. Politravma: travmaticheskaya bolezn, disfunktsiya immunnoy sistemy, sovremennaya strategiya lecheniya. [Multiple traumas: wound diseases, immune dysfunction, modern treatment strategy]. Moscow, GEOTAR-Media Publ., 2008, 608 p.
8. Gumanenko E.K., Lebedev V.F., Petrov А.N. et al. Structure of infectious complications of multiple trauma. Infeksii v Khirurgii, 2008, vol. 6, pp. 21.
9. Gumanenko E.K., Nemchenko E.S., Gavrilin S.V. et al. C-reactive protein and cytokines in multiple trauma. Obschaya Reanimatologiya, 2007, vol. 3, no. 5-6, pp. 19-23. (In Russ.)
10. Guryev S.E., Tanasienko P.V. Description of infectious complications in those with multiple trauma. Travma, 2013, vol. 14, no. 1, pp. 52-54. (In Russ.)
11. Deryabin I.I., Nasonkin O.S. Travmaticheskaya bolezn. [Trauma disease]. Leningrad, Meditsina Publ., 1987, 304 p.
12. Egorova N.I., Vlasenko А.V., Moroz V.V. et al. Ventilator-associated pneumonia: diagnostics, prevention, treatment (current state). Obschaya Reanimatologiya, 2010, vol. 6, no. 1, pp. 79-88. (In Russ.)
13. Zhdanuyk A.S. Nosocomial pneumonia in trauma patients: results of the prospective observational study. Klinicheskaya Mikrobiologiya i Antimikrobnaya Khimioterapiya, 2010, vol. 12, no. 2, pp. 106-115. (In Russ.)
14. Zarnadze N.R. Posttravmaticheskaya pnevmoniya pri zakrytoy travme grudi, perelomakh reber. Diss. kand. med. nauk. [Post-traumatic pneumonia in closed chest trauma, fractured ribs. Cand. Diss.].St. Petersburg, 2007, 139 p.
15. Karpun N.А., Moroz V.V., Klimova G.M. et al. Prevention of nosocomial infections of respiratory tract. Obschaya Reanimatologiya, 2007, vol. III, no. 3, pp. 100-104. (In Russ.)
16. Lebedev V.F., Gavrilin S.V., Khoroshilov I.E. Sepsis: system inflammation or metabolic default? Sb. materialov XI s'ezda Federatsii anesteziologov i reanimatologov. [Abstract Book of the XI Congress of Anesthesiologists and Emergency Physicians Federation]. St. Petersburg, 2008, pp. 180-182. (In Russ.)
17. Lebedev V.F., Kozlov V.K., Gavrilin S.V. et al. Immunoterapiya rekombinantnym interleykinom 2 tyazhelykh raneniy i travm. [Immune therapy with recombinant interleukin-2 of severe wounds and injuries]. St. Petersburg, SPbGU Publ., 2001, 70 p.
18. Lebedev V.F., Neymark M.I., Kirov M.Yu. Results of multi-centered prospective clinical study of efficiency of recombinant interleukin-2 in the comprehensive intensive therapy of sepsis. Intensivnaya Terapiya, 2007, no. 3, pp. 20-31. (In Russ.)
19. Malysh I.R., Kozlov V.K., Zgrzheblovskaya L.V. Profile of circulating cytokines and their release by mononuclear cells in the changes of post-trauma period in those with multiple trauma. Tsitokiny i Vospaleniye, 2016, vol. 2007, no. 3, pp. 49-56. (In Russ.)
20. Moroz V.V., Golubev А.M., Kuzovlev А.N., et al. Acute pulmonary lesions in pneumonia. Obschaya Reanimatologiya, 2008, vol. 4, no. 3, pp. 106-111. (In Russ.)
21. Moroz V.V., Golubev А.M., Kuzovlev А.N. et al. New diagnostic candidate molecular biomarkers of acute respiratory distress-syndrome. Obschaya Reanimatologiya, 2014, vol. 10, no. 4, pp. 6-10. (In Russ.)
22. Mustafin T.I., Kudoyarov R.R. Actual issues of diagnostics and treatment of nosocomial pneumonia. Meditsinsky Vestnik Bashkirostana, 2012, vol. 7, no. 4, pp. 73-77. (In Russ.)
23. Nemchenko N.S., Boyarintsev V.V., Gavrilin S.V.et al. State of immune system in various severity of post-traumatic sepsis. Аktualnye Problemy Neotlozhnoy Khirurgii, 2005, pp. 303-304. (In Russ.)
24. Ogarkov P.I., Boyarintsev V.V., Gavrilin S.V. Nosocomial infection as a modern surgical problem. Ambulatornaya Khirurgia, 2005, no. 3, pp. 3-6. (In Russ.)
25. Protsenko D.N., Gelfand B.R., Yakovlev S.V. et al. Risk factors of development and unfavorable outcomes of nosocomial infection associated with artificial pulmonary ventilation in the patients with severe trauma. Consilium Medicum, 2002, vol. 4, URL: old.consilium-medicum.com?
26. Rivzanova F.F., Pikuza O.I. Genetic diagnostics: polymorphism of cytokine genes. Prakticheskaya Meditsina, 2010, no. 45, pp. 41-43. (In Russ.)
27. Samokhvalov I.M., Schegolev А.V., Gavrilin S.V. et al. Аnesteziologicheskaya i reanimatologicheskaya pomosch' postradavshim s politravmoy. [Anasthesiological and reanimatological care for those with multiple trauma]. St. Petersburg, InformMed Publ., 2013, 144 p.
28. Smelaya T.V., Kuzovlev А.N., Moroz V.V. et al. Molecular genetic factors of nosocomial pneumonia and acute respiratory distress-syndrome. Obschaya Reanimatologiya, 2015, vol. 11, no. 3, pp. 24-38. (In Russ.)
29. Sovalkin V.I., Pomorgaylo E.G., Sabitova O.N.et al. Role of genetic polymorphism of tumor necrosis factor α G-308А, interleukin -1β С-511Т and interleukin-10 G082А in the development of lingering course of nosocomial pneumonia. Bulleten' Sibirskoy Meditsiny, 2013, vol. 12, no. 6, pp. 54-61. (In Russ.)
30. Sokolov V.A. Mnozhestvennye i sochetannye travmy. [Multiple and concurrent injuries]. Moscow, GEOTAR-Media Publ., 2006, 512 p.
31. Khromov А.А., Linnik S.А. Infectious complications in the patients with multiple and concurrent trauma. Fundamentalnye Issledovaniya, 2015, no. 1, pp. 1245-1249. (In Russ.)
32. Khubutiya M.Sh., Shabanov А.K., Chernenkaya T.V. et al. Infectious pulmonary complications in the intensive care unit in those with concurrent trauma. Obschaya Reanimatologiya, 2011, vol. VII, no. 4, pp. 24-27. (In Russ.)
33. Tsarev A.V. Dekasan in the prevention and treatment of ventilator-associated pneumonia in patients with multiple trauma. Meditsina Neotlozhnykh. Sostoyaniy, 2012, no. 7-8, pp. 80-84. (In Russ.)
34. Chuchalin A.G. Nosocomial pneumonia: practical guidelines on diagnostics, treatment and prevention. Klinicheskaya Mikrobiologiya i Antimikrobnaya Khimioterapiya, 2005, vol. 7, no. 1, pp. 4-31. (In Russ.)
35. Shabanov А.K., Khubutiya M.Sh., Bulava G.V. et al. Changes in the level procalcitonin in the development of nosocomial pneumonia in those with severe concurrent trauma. Obschaya Reanimatologiya, 2013, vol. 9, no. 5, pp. 11-18. (In Russ.)
36. Shteynle A.V. Pathophysiology and modern principles of treatment of severe concurrent traumas (Part 1). Sibirsky Meditsinsky Journal, 2009, no. 3, pp. 119-127. (In Russ.)
Review
For citations:
Prokhorov A.V., Khalimov Yu.Sh., Gayduk S.V., Gavrilin S.V., Meshakov D.P., Chepel A.I. CURRENT STATE AND PERSPECTIVE OF DIAGNOSTICS OF NOSOCOMIAL PNEUMONIA IN THOSE INJURED WITH MULTIPLE TRAUMA. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2017;14(5):66-72. (In Russ.) https://doi.org/10.21292/2078-5658-2017-14-5-66-72
Email this article 