Detoxification therapy for pneumonia
Inflammation of the lungs (pneumonia) is characterized by moderate, rarely moderate course. In some cases - in children and older people, with comorbidity and immunodeficiency, symptoms of intoxication appear in pneumonia in the form of impaired consciousness and breathing problems, up to the development of acute respiratory failure.
The basis of emergency care for a patient with pneumonia is provided for detoxification therapy.
Symptoms of intoxication with pneumonia
The syndrome of intoxication in pneumonia occurs in response to the inflammatory process in the lungs and is accompanied by the reaction of the main systems and organs - immune, cardiovascular, nervous and endocrine. The severity of manifestations, as a rule, depends on the scale and magnitude of the main pathological process (inflammation) and associated diseases.
Manifestations of moderate intoxication in pneumonia:
- lack of vitality, weakness and rapid increase in fatigue;
- body temperature is elevated (fever or subfebrile condition) and sweating;
- lack or loss of appetite and weight loss.
In moderate intoxication, besides the listed symptoms, the following symptoms may be associated:
- 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 the case of severe intoxication with pneumonia, the fever reaches febrile numbers (above 38 ° C), proceeds together with headache, nausea and vomiting. In the absence of medical care and an increase in the state, convulsions and manifestations of delirium occur, which indicates intoxication psychosis.
Symptoms of intoxication in pneumonia in children
Children are at increased risk for the occurrence of toxemia in pneumonia. They are characterized by a staged development of the process with such manifestations:
- stage of general arousal - the work of all systems and organs in the child's body is increased - psychologically he is excited and restless, there is frequent heartbeat (tachycardia), acceleration of the function of the alimentary tract (vomiting, frequent bowel movements, liquid stool);
- stage of suppression - reduction of the function of the body - the pathological calm and indifference of the child to the outside world, possibly a violation of the state before the development of a stupor, prevails;
- stage of impairment and loss of consciousness.
Intoxication of the body in pneumonia in children has features of the type of internal toxicosis. The magnitude of the lesion depends on the degree of dehydration:
- Grade I is manifested by a moderate feeling of thirst against the background of slight dryness of the mucous membranes with a total weight loss of up to 5%;
- Grade II is characterized by an increase in dryness of the skin and mucous membranes in combination with a depression of the spring and decrease in turgor (elasticity) of tissues, a drop in blood pressure and compensatory tachycardia, frequent - more than 10 times per day, stools and vomiting, weight loss ranges from 5 to 10% ;
- Grade III is accompanied by serious signs - dry mucous and loose skin, pointy facial features, deaf heart sounds and shortness of breath, impaired kidney and intestinal function, and a weight deficit of more than 10%.
The buildup of manifestations that are dangerous for the patient’s life serves as an indication for immediate hospitalization and an adequate set of medical measures.
The main components of the inpatient treatment of pneumonia
- Etiotropic treatment - aimed at combating the cause of the disease (causative agent) - antiviral drugs are prescribed for viral pneumonia, antibiotics for bacterial causes of the disease.
- Detoxification therapy for pneumonia is carried out using infusion therapy or connecting hemodialysis in difficult situations when the patient's body is unable to cope with the intoxication load due to the disease.
- Funds aimed at counteracting the development of acute respiratory and heart failure.
Therapy of poisoning with pneumonia is most beneficial in the hospital because of:
- ensuring in hospital an appropriate bed rest and food;
- the availability of parenteral (intravenous and intramuscular) administration of drugs;
- the implementation of the necessary volumes of detoxification therapy under the round-the-clock supervision of medical personnel.
Purposes and means of detoxification therapy
Detoxification therapy is carried out to solve such problems:
- removal and purification of the patient's body from toxic compounds (infectious agents and products of their vital activity, kneaded own toxic agents - endo and exotoxins);
- normalization and restoration of water-salt and electrolyte exchanges;
- replenishment of water deficiency (dehydration) and blood thinning (hemodilution);
- restoration of blood microcirculation and renewal of the functioning of organs, elimination of tissue hypoxia.
During detoxification therapy they use crystalloid (isotonic solution of sodium chloride, glucose, Trisol, Acesol and others) and colloid (Stabizol, gelatins, dextrans - Reopoliglyukin, Hemodez, Reoglyuman) solutions and parenteral nutrition.
Crystalloids are used to compensate for the deficit of intracellular fluid and restore water-electrolyte balance. Colloids normalize the amount of circulating blood and microcirculation, provide tissue needs for oxygen and nutrients, establish metabolic processes, the work of the lungs and kidneys.
For parenteral nutrition, solutions of vitamins, amino acids, microelements and fats, as well as their combinations, are used to compensate for excessive energy costs and weight loss.
This procedure is monitored by measuring the pulse size and pressure, respiration rate and heart rate. An important indicator is the ratio of the injected and the amount of fluid taken to prevent hypervolemia (increasing the amount of circulating blood) and pulmonary edema.
In emergency cases, especially in children in an emergency order, use:
- plasmapheresis (blood purification by removing the liquid portion - plasma together with toxic compounds);
- hemosorption (blood is purified on sorbents outside the body);
- hemodialysis (blood passes through the hemodialysis membrane and is diffused 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 healing.
Thus, when identifying symptoms of intoxication due to pneumonia, it is necessary to seek qualified medical care in a hospital.
Timely infusion detoxification therapy will prevent serious consequences - damage to the kidneys, liver and central nervous system.