A method for the treatment of infected infants with respiratory distress syndrome

 

(57) Abstract:

The invention relates to medicine, in particular to neonatologie, and is intended for the treatment of respiratory distress syndrome in newborns. On the second day after birth newborns injected sachitano - endotracheal and intramuscularly - lacapere in a dose of 5,000 IU, while endotracheal lacapere injected once or three times, and intramuscularly four or five times a day, on a course of 3-5 treatments. This invention helps prevent postnatal pneumonia or quick resolution in case.

The invention relates to medicine, namely to neonatology, and can be used for the treatment of severe respiratory distress syndrome (RDS) in newborns with intrauterine infection, were on artificial lung ventilation (ALV).

There is a method of treatment of infants who are born with on prolonged mechanical ventilation, antibiotics to suppress microbial contamination of the respiratory tract and the development of such complications of mechanical ventilation, as postnatal pneumonia, or to prevent the risk of occurrence of intrauterine infection of Virunga treatment observed adverse effects, which lead to the development of dysbiosis and immunodeficiency, allergies infants.

A method for the treatment of infected newborns with RDS through the introduction of lacenterra (LF) endotracheal and intramuscularly every other day for 3-5 treatments on the course of treatment.

The method is as follows.

After preliminary tracheobronchial lavage is performed instillation of the trachea and bronchi through an endotracheal tube lacenterra at a dose of 5,000 IU and reconnected to the ventilator. These procedures combine with intramuscular injection of 5000 ME LF. The course is 3-5 installations and intramuscular injection every other day.

Under supervision there were 10 babies under the age of 7 days, from birth developed severe clinic RDS, the treatment of which was used as a ventilator. All children develop PA background adversely flowed pregnancies and childbirth, had clinical and laboratory data for intrauterine infection. Including two newborns were observed clinic congenital pneumonia.

On the background of traditional treatment control cytogram tracheobronchial lavagno fluid and hemogram in the first three days after Christmas, Teatralny infection in infants with RDS, located on a ventilator.

In newborns treated with LF, according to the cytograms of tracheobronchial lavagno fluid decreased the total number of cells counted in 10 fields of view, 6-11 times, neutrophils in 3-5 times. Clinically in children with congenital pneumonia has been a rapid regression of pathological symptoms and resolution of the inflammatory process in the first three days, the second in five days. Infected children with RDS long IVL implementation of infection in the treatment of LF in the form of postnatal pneumonia was not observed when traditional therapy was observed in 40% of cases.

Example 1

Newborn N. Diagnosis: Intrauterine infection, congenital pneumonia, II pregnancy going on in the background threat of termination in 5 and 30 weeks, anemia I tbsp. all over, preeclampsia mild, chronic placental insufficiency and fetal hypoxia, colpitis. The female adrenogenital syndrome, postpubertatne form, nephroptosis I tbsp.

Genera I in period. Waterless period - 10 hours 55 minutes, back water meconium. A girl was born with a weight 3950 g, a growth of 57 see Assessed by Apgar scores at 5-6 points.

Clinical condition was regarded as serious since the first litative was conducted with weakening, all fields were heard scattered dry rales, BH 52 minutes On the 4th day status has sharply worsened: increased indrawing compliant places a chest auscultation breath became hard, has increased the number of dry rales, appeared diffuse cyanosis, apnea to 10 seconds. When the lavage of the tracheobronchial tree was Syrovatka Muco-purulent discharge. Given the deterioration, the child was transferred on a ventilator mode volume ventilation with supply of 40% oxygen.

On radiographs of the chest with right - sided pneumonia. In the blood - absolute neutrophilic leukocytosis character with stab shift: Le 28,6*109/l, p - 6% - 70%. In they tracheobronchial lavage 4 days: the total number of cells 120/10, neutrophils - 90%, epithelium - 10%.

Antibiotic treatment of the newborn was held from birth, but was negative dynamics. Therapy LF start is with 4 days. A single dose of 5,000 IU endotracheal and 5 intramuscular injection of 5,000 IU a day. The condition improved after 15 hours from the beginning of mechanical ventilation, the child was transferred to SDPD through an endotracheal tube, 3 hours later - excubitor and in the following two days were on SDPD through 2 bow to the C nasopharynx were sanitize mucous discharge. Blood leukocytosis decreased to 18.0*109/l indicators leukocyte approached age values. In the analysis of the aspirate from the nasopharynx: the cells of a flat epithelium - 70%, neutrophils - 25%, lymphocytes - 5%.

The child was discharged from the maternity home at the age of 15 days in a satisfactory condition.

Example 2

The newborn Was Diagnosed with RDS II, aspiration syndrome, NAM II. I pregnancy occurring on the background of early toxicity, obesity, anemia 1 tbsp., nephropathy. Genera I, in time, through the birth canal. Labor - single, taut cord entanglement around his neck. The boy was born weighing 4440 g, a growth of 58 see Assessed by Apgar scores at 5-6 points.

State of birth severe: marked indrawing compliant seats of the chest, diffuse cyanosis of the skin, auscultatory all fields have been diminished breath, listen to fine basal rales, when rescue trachea removed a significant amount of light of amniotic fluid. Given the clinic, the child was transferred on a ventilator mode normogastria feed 40% oxygen.

In the blood at birth relative neutrophilic leukocytosis character with stab shift: Les 10,7*109/l, p - 7% - 68%. In the, is pitali cylindrical - 22%, lymphocytes - 9%. On radiographs of the chest - pneumopathy, edematous form.

Antibiotic therapy was conducted with the first day of life, but, given the high risk of implementation of intrauterine infection, with 2 day was started therapy LF. He was introduced endotracheal at a dose of 5,000 IU three times and intramuscular injection of 5,000 IU four times a day.

The child with the positive dynamics: respiratory disorders decreased during the 4 days he was transferred to spontaneous breathing. Radiographically on the 5th day is improving, but remains moderate increased vascular pattern. In the clinical analysis of blood stab shift was not observed. In they the total number of cells decreased to 20/10, neutrophils up to 20%.

The child on the 8th day he was transferred to the II stage of newborns.

The proposed method of treatment is well tolerated by newborns, no complications and reduced length of stay in the ICU. The positive effect begins to occur during the first two days after beginning therapy lacenterra.

The source of information

1. Beloborodov N. In., Biryukov, A. C. Roanne with respiratory distress syndrome by administration of drugs, characterized in that the quality of drug use lacapere that is administered to the newborn baby from the second day after birth in a dose of 5,000 IU sachitano - endotracheal and intramuscularly, with endotracheal lacapere injected once or three times, and intramuscularly four or five times a day, on a course of 3-5 treatments.

 

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FIELD: medicine, anesthesiology-resuscitation, infectology, detoxication.

SUBSTANCE: the innovation suggested interrupts infectious-toxic shock, moreover, after that it is necessary to prescribe peroral intake of Reaferon-EC-Lipint at the dosage of 10000 - 15000 U/kg. Then one should sample patient's blood to obtain leukocytes to be washed and diluted in 0.9%-NaCl solution, activated due to incubation with immunophan and intravenously injected for a patient. Then comes peroral intake of Reaferon-EC-Lipint at the dosage of 10000 - 15000 U/kg once daily for 5 d. The innovation enables to decrease the number of complications and lethality due to decreasing immunodeficiency.

EFFECT: higher efficiency of therapy.

3 ex, 1 tbl

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