Detoxification therapy for pneumonia
Inflammation of the lungs (pneumonia) is characterized by a moderate, less often mild course. In some cases - in children and older people, with concomitant pathology and the state of immunodeficiency, there are symptoms of intoxication with pneumonia in the form of impaired consciousness and breathing problems, up to the development of acute respiratory failure.
At the heart of emergency care for patients with pneumonia, detoxification therapy is provided.
Symptoms of intoxication with pneumonia
Syndrome of intoxication with pneumonia occurs in response to the inflammatory process in the lungs and is accompanied by the reaction of the basic systems and organs - immune, cardiovascular, nervous and endocrine. The severity of manifestations, as a rule, depends on the scale and magnitude of the underlying pathological process (inflammation) and concomitant diseases.
Manifestations of moderate intoxication in pneumonia:
- lack of vitality, weakness and rapid increase in fatigue;
- body temperature increased (fever or subfebrile condition) and the presence of sweating;
- absence or loss of appetite and weight loss.
In case of moderate intoxication, in addition to the listed signs, it is possible to attach the following symptoms:
- nausea and quite often vomiting;
- cough and significant shortness of breath, the intensity of which exceeds physical effort.
Such patients have an exhausted appearance with pale or grayish skin. With prolonged intoxication, anemia develops.
In case of severe intoxication with pneumonia, fever reaches febrile digits (above 38 ° C), occurs in conjunction with head pain, nausea and vomiting. In the absence of medical care and the growth of the state there are convulsions and delusions, which indicates an intoxication psychosis.
Symptoms of intoxication with pneumonia in children
Children are at increased risk of developing toxicosis in cases of pneumonia. They are characterized by the stage development of the process with such manifestations:
- stage of general excitation - the work of all systems and organs in the child's body is increased - psychologically it is agitated and restless, frequent palpitations (tachycardia), acceleration of the function of the alimentary canal (vomiting, frequent bowel movement, liquid stools);
- the stage of suppression - a decrease in the function of the body - the pathological calmness and indifference of the child to the surrounding world prevail, possibly a violation of the state before the development of a stupor;
- stage of impairment and loss of consciousness.
Intoxication of the body in case of pneumonia in children has peculiarities in the type of internal toxicosis. The magnitude of the lesion depends on the degree of dehydration:
- I degree is manifested by a moderate thirst on the background of insignificant dryness of the mucous membranes with a total weight loss of up to 5%;
- II degree is characterized by an increase in the dryness of the skin and mucous membranes in combination with the fading of the fontanel and the decrease in turgor (elasticity) of tissues, a drop in arterial pressure and compensatory tachycardia, frequent stools and vomiting more than 10 times a day, weight loss is in the range of 5 to 10% ;
- III degree is accompanied by serious signs - dry mucous and flabby skin, pointed facial features, dull heart tones and shortness of breath, disruption of the kidneys and intestines, and a deficit of more than 10%.
Acceleration of life-threatening manifestations serves as an indication for immediate hospitalization and an adequate set of medical measures.
The main components of inpatient treatment of pneumonia
- Etiotropic treatment - is aimed at combating the cause of the disease (pathogen) - in case of viral pneumonia, antiviral drugs are prescribed, in the case of a bacterial cause of the disease - antibiotics.
- Detoxification therapy for pneumonia is carried out with the help of infusion therapy or the connection of hemodialysis in difficult situations, when the patient's body is unable to cope with the toxic load due to the disease.
- Means aimed at counteracting the development of acute respiratory and heart failure.
Therapy of poisoning in pneumonia is most favorably performed in a hospital due to:
- provision of appropriate bed rest and nutrition in the hospital;
- accessibility of parenteral (intravenous and intramuscular) drug administration;
- the implementation of the necessary volumes of detoxification therapy under round the clock supervision of medical personnel.
Objectives and means of detoxification therapy
Disintoxication therapy is used to solve such problems:
- elimination and purification of the patient's body from toxic compounds (pathogens of infection and products of their vital activity, accumulated own poisonous substances - endo and exotoxins);
- normalization and restoration of water-salt and electrolyte exchanges;
- replenishment of water deficiency (dehydration) and liquefaction of blood (hemodilution);
- restoration of blood microcirculation and the resumption of the functioning of organs, elimination of hypoxia of tissues.
Methods of detoxification
During the detoxification therapy, crystalline (isotonic sodium chloride solution, glucose, Trisol, Acesol and others) and colloidal solutions (Stabisol, gelatin, dextrans - Reopoliglyukin, Hemodez, Reogluman) are used for parenteral nutrition.
Crystalloids are used to compensate for the deficiency of intracellular fluid and restore water-electrolyte equilibrium. Colloids normalize the amount of circulating blood and microcirculation, provide tissue needs in oxygen and nutrients, establish metabolic processes, and work of the lungs and kidneys.
For parenteral nutrition use solutions of vitamins, amino acids, trace elements and fats, as well as their combination to compensate for excessive energy expenditure and weight loss.
Monitor the procedure by measuring the pulse and pressure, respiration rate and heart rate. An important indicator is the ratio of injected and the amount of fluid withdrawn to prevent hypervolemia (increase in the number of circulating blood) and pulmonary edema.
In emergency cases, especially in children in urgent order, apply:
- plasmapheresis (purification of blood by the removal of the liquid part - plasma along with toxic compounds);
- hemosorption (blood is purified on sorbents outside the body);
- hemodialysis (the blood passes through the hemodialysis membrane and is purified by the diffusion method, in addition, excess water is removed from it).
The appointment of enterosorbents and hepatoprotectors inside is characterized by a positive effect and promotes recovery.
Thus, when symptoms of intoxication are detected due to pneumonia, it is necessary to seek qualified medical care in a hospital setting.
Timely spent infusion detoxification therapy will prevent severe consequences - kidney, liver and central nervous system damage.