USMF logo

Institutional Repository in Medical Sciences
of Nicolae Testemitanu State University of Medicine and Pharmacy
of the Republic of Moldova
(IRMS – Nicolae Testemitanu SUMPh)

Biblioteca Stiintifica Medicala
DSpace

University homepage  |  Library homepage

 
 
Please use this identifier to cite or link to this item: http://hdl.handle.net/20.500.12710/9851
Title: Terapia intensivă în pneumonia comunitară complicată cu detresă respiratorie (caz clinic)
Other Titles: Intensive care in community-acquired pneumonia complicated by acute respiratory distress syndrome (clinical case)
Authors: Odajiu, Otilia
Zubarev, Chiril
Gîrbu, Lucia
Dumitraş, Tatiana
Guţu-Bahov, Cornelia
Cojocaru, Victor
Keywords: pneumonia;respiratory distress
Issue Date: 2018
Publisher: The Scientific Medical Association of the Republic of Moldova
Citation: ODAJIU, Otilia, ZUBAREV, Chiril, GÎRBU, Lucia, et al. Terapia intensivă în pneumonia comunitară complicată cu detresă respiratorie (caz clinic) = Intensive care in community-acquired pneumonia complicated by acute respiratory distress syndrome (clinical case). In: The Moldovan Medical Journal. 2018, vol. 61 (AIC congress issue), september, p. 28. ISSN 2537-6381.
Abstract: Introducere: Pneumonia comunitară (PC) severă prezintă și astăzi o provocare pentru secțiile de terapie intensivă, rata mortalității atingând 23-27%. Material și metode: Analiza retrospectivă a cazului pacientului spitalizat cu PC severă în secția de terapie intensivă, conduita terapeutică fiind realizată conform recomandărilor SSC-2016. Rezultate: Pacient de 38 ani, diagnosticat cu PC bilaterală complicată cu detresă respiratorie faza II, scor qSOFA 2 puncte, scor APACHE 15 puncte, scor SOFA 6 puncte, scor CURB-65 3 puncte, scor PSI 135 puncte (clasa IV). S-a administrat tratament intensiv prin suport ventilator (PEEP, Vt, PΔ). Ghidajul antibioticoterapiei cu procalcitonina și de escaladare, terapia infuzională și vasopresoare monitorizată cu ajutorul PiCCO au avut un efect pozitiv asupra prognosticului, cu supraviețuirea pacientului, vindecarea clinică și rezoluția radiologică a pneumoniei. Concluzii: Intervenţia terapeutică imediată, la prima oră de spitalizare a pacientului în secţia de terapie intensivă, prin aplicarea recomandărilor SSC-2016, a permis rezolvarea pneumoniei comunitare severe, inițial pronosticul fiind rezervat.
Introduction: Severe community-acquired pneumonia (CAP) remains a challenge for intensive care units (ICU), with mortality rates reaching 23-27%. Material and methods: A retrospective analysis of a clinical case of a patient hospitalized with severe CAP in ICU, the management being performed according to SSC-2016 recommendations. Results: A 38-year old male, diagnosed with CAP complicated by acute respiratory distress syndrome, phase II, scored qSOFA 2 points, APACHE 15 points, SOFA 6 points, CURB-65 3 points and PSI 135 points (class IV). Intensive treatment was initiated by ventilatory support (PEEP, Vt, PΔ). The guidance of antibacterial therapy and its deescalation using procalcitonin, PICCO monitoring of infusion therapy and vasopressors had a positive role over prognosis, with patient`s survival, clinical cure and radiological resolution of pneumonia. Conclusions: Immediate actions, in the first hour of hospitalization in ICU, by applying SSC-2016 recommendations, allowed severe CAP to be successfully treated, with the patient initially reserved for prognosis.
metadata.dc.relation.ispartof: The Moldovan Medical Journal: The 5th International Congress of the Society of Anesthesiology and Reanimatology of the Republic of Moldova, 16th Edition of the International Course of Guidelines and Protocols in Anesthesia, Intensive Care and Emergency Medicine, 28th Meeting of the European Society for Computing and Technology in Anesthesia and Intensive Care September 27-29, 2018, Chisinau, the Republic of Moldova
URI: http://moldmedjournal.md/wp-content/uploads/2018/09/61-4-ATI-Congres.pdf
http://repository.usmf.md/handle/20.500.12710/9851
ISSN: 2537-6381
Appears in Collections:The Moldovan Medical Journal, Vol. 61, September 2018 AIC Congress Issue



Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

 

Valid XHTML 1.0! DSpace Software Copyright © 2002-2013  Duraspace - Feedback