Tetiana Khomazyuk1, Sergei Slesarenko2 and
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%.
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).
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
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.
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.
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