Horodkova Y. Improvement of Intensive Care for Community-acquired Pneumonias in Infants and Preschool-Age Children

The thesis is devoted to the development of a differentiated approach to the choice of intensive care (IC) methods for infants and preschool-age children with complicated community-acquired pneumonias (CCAP) and the improvement of empirical antibacterial therapy (ABT) at the local level. The paper has analyzed the diagnostic findings and treatment outcomes in 91 infants and preschool-age children with CCAP of Degree IV-V of severity, who were undergoing treatment at the Pediatric Intensive Care Unit (PICU) of the Municipal Non-Commercial Enterprise the Municipal Pediatric Hospital No. 5 of the Zaporizhzhia City Council and workup results in 28 somatically apparently health children. This was a study of two stages: retrospective analysis (from 2001 till 2016) and prospective, single centre experience, cohort study (from 2017 till 2020). In the course of examination, patients, who were undergoing discrete plasmapheresis (PP) at the РICU, were enrolled into the 1st retrospective (n=39, 32,77 %) and 3rd (n=11, 9,24 %) prospective treatment groups; patients, who were undergoing background intensive therapy, were enrolled into the comparison retrospective group (2nd, n=24, 20,17 %) and comparison prospective group (4th, n=17, 14,29 %). The children, who were preparing for an elective surgery at the Departments of Surgery or Urology, were enrolled into the control, 5th group (somatically apparently healthy children, n=28). In the treatment group 1st, two subgroups were identified depending on the children’s age: 1A – infants (1-3-year 9 old), n=18, 1B – preschool-age children (3-7-year old), n=21; also, the patients in the second group were similarly assigned to Subgroups 2A (n=11) and 2B (n=13). The groups are comparable in age, sex, degree of pneumonia severity on the children’s admission to the PICU (p>0,05). The observation results of 1-4 groups were evaluated on admission to the PICU (Ι stage), on Day 1 (ΙΙ stage), on Day 2 (ΙΙΙ stage) of background IC; in Group 1 – before PP (ΙV stage), in a day after PP (V stage), in three days after PP (VΙ stage); in Groups 2 and 4 – on Days 3 and 5 of background IC (ΙV and V stages); in the control group – prior to the surgical intervention.