Infectious-inflammatory lesions of the respiratory system occupy a leading place among the structure of childhood morbidity not only in Ukraine, but also all over the world. Significant features of the respiratory pathology course in children are the etiological structure of the infectious pathogen and the severity of the course of the infectious-inflammatory process, that determine a multiform therapeutic approach and the place of conducting medical measures. The standard diagnostic procedures existing today are accompanied by obtaining in a number of cases insufficiently objective results, that makes impossible to choose the timely optimal therapeutic approach. This induces to the search for the new non-invasive biological markers which would make it possible to diagnose the etiology of pneumonia in children and predict the severe course of pulmonary pathology, and accordingly will allow to individualize the necessary therapy, that will reduce the risk of possible complications, accelerate the recovery stage and will be accompanied by medical, social and economic efficiency. Proceeding from this, thesis is devoted to the possibility of etiological diagnosis of pneumonia in children by using a complex of non-invasive diagnostic procedures, as well as improving the effectiveness of treatment of patients with infectious and inflammatory lesions of the lung tissue, by means of studying the prognostic value of the complex of the research results obtained.
It has been proved that a relatively milder course of the disease was observed in patients with bacterial pneumonia, since 50,7% of cases of patients with community-acquired pneumonia, caused by the SARS-CoV-2 virus, and only 29,9% of children of the comparison group were initially placed in the anesthesiology and intensive care unit when admitting to the hospital, as they needed prosthetics of respiratory function, correction of water and electrolyte balance and/or support of hemodynamics with clinical and epidemiological risk: OR – 2,4, RR – 1,5, AR – 0,2.
The results obtained give reason to believe that in children of clinical group I with severe community-acquired viral pneumonia who did not receive systemic glucocorticosteroids, there was a relative increase in the need for respiratory function protection by 90,0% (RRI = 0,9). In contrast, in children of clinical group II who had severe bacterial pneumonia and received intravenous glucocorticosteroid therapy, the risk of invasive mechanical ventilation necessity decreased 60,0% (RRR = 0,6).
Thus, the conducted dissertation research expands knowledge concerning clinical and laboratory diagnostics of pneumonia etiology in children, determination of the infectious-inflammatory process activity of the lung parenchyma, and also deepens the prediction of the severe course of infectious respiratory pathology and makes it possible to optimize individualized therapeutic approach using a complex of non-invasive diagnostic procedures.
