Semkovich Y. Differential and diagnostic criteria of pneumonia treatment approach in children under 3 years complicated by toxic syndrome and purulent endobronchitis.

The scientific work is devoted to improve diagnosis and treatment of children under 3 year pneumonia complicated by toxic syndrome and purulent endobronchitis. The study involved 289 children under 3 year suffering from complications of pneumonia. Among them in 129 cases (44,6%) pneumonia was complicated by toxic syndrome, and in 160 cases (55,4%) by purulent endobronchitis. The 148 children got controlled treatment on prospective stages. It has been proved that toxic syndrome and purulent endobronchitis with different clinical progression and mediator aggression (according to the markers of systemic activation of neutrophils) are the leading complications of pneumonia; this requires their clear differentiation. Significant disturbance of acid-base balance, prooxidant-antioxidant system, activation of catabolic processes, and inflammation activity (neutrophil elastase growth) are pathognomonic for toxic syndrome and purulent endobronchitis, and are the results of homeostasis abnormalities in children with complicated pneumonia. It has been proved that addition to the standard treatment of the infusion therapy according to the infusion ratio and Budesonide inhalation in case of pneumonia complicated by the toxic syndrome, and correction of water pressure and Ambroxol inhalation in case of purulent endobronchitis, and pron-position usage in case of control lung ventilation independently by complications predetermine correction of acid-base balance disorders, significant decrease of lipid peroxidation activity, activation of antioxidant system enzymes, normalization of neutrophil elastase. These allow achieve positive clinical and pharmacoeconomic effects and improve treatment of children under 3 year pneumonia complicated by toxic syndrome and purulent endobronchitis in shorter time.