Perhimpunan Dokter Paru Indonesia - Features of pneumonia diagnostics in burn trauma patients
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Features of pneumonia diagnostics in burn trauma patients

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Tetiana Khomazyuk1, Sergei Slesarenko2 and Lyudmila Novozhenina1
1Propedeutic of Internal Medicine, Dniepropetrovsk Medical Academy, Dniepropetrovsk, Ukraine, 2City Hospital, Dniepropetrovsk, Ukraine

Pneumonia diagnostics in patients with burn trauma is an actual problem as lesion of respiratory organs in the general structure of polyorgan insufficiency makes 88,9%.

Purpose: studying features of pneumonia course and informative criteria of early diagnostics in patients with burn trauma depending on age, area, depth of defeat, airways burn (AB).

Methods: retrospective analysis of medical records of 749 patients and 40 autopsies in age groups from 18 to 60 and over 60 with burns of 2% to 95% of body surface.

Results: in patients aged before 60 with superficial burns of more than 40% of body surface, pneumonia developed in 38,1% of cases, with deep burns of more than 20% - in 43,9%, and in the senior age group - in 53,6% of cases in case of smaller area of burns (more than 20% and 5% respectively). Physical symptoms of pneumonia were stated only in 34,5% of cases. In AB pneumonia developed more often by 1,37 times. Autopsy analysis showed that in the first days in deep burns pneumonia foci were detected in 83,3%, in 22,2% - with areas of micro-abscesses, and 46,43% cases were not diagnosed during lifetime.

Conclusions: standard clinical and laboratory diagnostic criteria of pneumonia are leveled as a rule, by manifestations of burn disease. The X-ray research of the thorax in 2 projections is obligatory on day 2-3 in patients over 60 years even in a mild burn trauma without AB and in all patients in AB presence, despite absence of physical data in the lungs. Correction of antibiotic treatment should be carried out by monitoring microbic landscape of sputum, wound surface, serological diagnostics and local resistance of microflora.

Source : http://erj.ersjournals.com/content/44/Suppl_58/4645
Image : http://www.vereencenter.com/...

PDPI Sulawesi Selatan & Utara. 16/09/17.

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