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Pneumonitis caused by food and vomit. Aspiration pneumonia

ICD-10 code J69.0
Diagnostics
When diagnosed
Mandatory
The level of consciousness, the frequency and effectiveness of breathing, heart rate, blood pressure, CVP, body temperature, condition of the skin
R-graph of the chest
ECG
Laboratory studies: hemoglobin, red blood cells, white blood cells, blood count, total protein, bilirubin, urea, creatinine, electrolytes, enzymes, blood coagulation (platelets, APTT, IPT), en. urine microscopy sediment
Macroscopy bacterioscopy
Bronchoscopy

Additional (according to indications)
Ultrasound of the abdominal cavity
ECHO cardiography
Respiratory Index (pO2MO2)
Serological diagnosis During treatment
Monitoring according to cl 1.5
Hemoglobin Saturation
Repeated laboratory tests, chest x-rays, sputum, blood cultures, biological media for microflora, sensitivity to antibiotics; bacterioscopic and serological studies - according to indications
Evaluation of the effectiveness of antibiotic therapy at least every 3 days of treatment

Treatment
The most important task of intensive care is to ensure adequate ventilation of the lungs and blood oxygenation. When applying mechanical ventilation, it is imperative to use antibacterial filters. If regurgitation is suspected, immediately aspirate the contents of the oral cavity, intubate the trachea, aspirate the contents of the trachea and bronchi. In the presence of food debris, gastric or intestinal contents - sanitation fibrobronchoscopy
In other cases, regular removal of the contents of the oral cavity, oxygen inhalation, ventilation with constant increased pressure through a dense face mask, with the ineffectiveness of these measures, tracheal intubation and mechanical ventilation.
Preferred pressure ventilation modes
Indications for emergency sanitation bronchoscopy are: the presence of food debris in the trachea, the detection of atelectasis during radiography of the lungs. Scheduled bronchoscopy is performed if it is impossible to provide adequate sanitation of the trachea, main and lobar bronchi. Gastric emptying using a probe. Venous access. Replenishment of circulating blood volume deficiency, correction of water-electrolyte disorders. Indications for bronchodilator and mucolytic therapy. Initial antibiotic therapy should include agents effective against gram-negative flora and anaerobes:
Cephalosporins of the II-III generation (cefoxitin i / m or iv 2.0 g after 6 hours or cefotaxime i / m or iv 3.0 g after 8-12 hours) in combination with aminoglycosides (amikocin / m or iv in 0.5 g after 8-12 hours). IV generation cephalosporins (iv cefepime 1.0–2.0 g after 12 hours) in combination with fluoroquinolones aminoglycosides (iv 0.2–0.4 g ciprofloxacin after 12 hours) in combination with macrolides (erythromycin iv 1.0 g after 6 hours) or with aminoglycosides
Carbapenems as monotherapy or in combination with aminoglycosides
Additionally, drugs that are active against anaerobic flora (metronidazole or clindamycin), with methicillin-resistant staphylococcal flora - glycopeptides (vancomycin)
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Pneumonitis caused by food and vomit. Aspiration pneumonia

  1. Aspiration pneumonia
    Deborah R. Van Pelt, DVM, MS 1. In what conditions is there a risk of developing aspiration pneumonia? • Impairment of consciousness (treatment with sedatives, diseases of the central nervous system, anesthesia). • Pathology of the oropharynx (cleft palate, rapid eating of food). • Esophagus pathology (anomaly of the vascular ring, peristalsis disorder, megaesophagus). •
  2. Aspiration pneumonitis, or Mendelssohn syndrome.
    This syndrome got its name from the author (C. L. Mendelson, 1946), who analyzed 66 cases of aspiration during general anesthesia during childbirth and identified a particular asthma-like reaction to acidic gastric contents without obstruction by food masses. For pregnant women, regurgitation, or passive gastroesophageal reflux, occurs when the pressure in the stomach is higher than in the esophagus
  3. Aspiration pneumonia in children
    A disease quite common in infancy associated with a violation of the act of swallowing (dysphagia) or, less commonly, with the presence of a tracheoesophageal fistula, compression of the esophagus by an abnormal vessel or tumor. Dysphagia can be the result of paresis of the soft palate, pharyngeal muscles, as well as the immaturity of the swallowing reflex. Aspiration of food occurs either during its intake, or later, with
  4. Pneumonia Acute pneumonia.
    In pregnant women, pneumonia often proceeds more severely due to a decrease in the respiratory surface of the lungs, high standing of the diaphragm, limiting lung excursion, and an additional burden on the cardiovascular system. The clinical picture of acute pneumonia is not different from that of non-pregnant. With the development of pneumonia shortly before childbirth, development should be delayed if possible
  5. Pneumonia in children
    Protocol code: 04-040а Profile: pediatric Stage: hospital Purpose of stage: 1. Relief of the inflammatory process in the lungs. 2. Elimination of DN symptoms, general intoxication, fever, restoration of lung excursion, disappearance of local physical data in the lungs, cough. Duration of treatment: 21 days ICD codes: J18 Pneumonia without specifying the pathogen J15.6 Pneumonia caused by
  6. Congenital Pneumonia
    Protocol code: 15-138a Profile: pediatric Stage: hospital Purpose of stage: 1. relief of respiratory and cardiovascular failure, symptoms of general intoxication; 2. normalization of percussion and auscultatory picture in the lungs; 3. normalization of laboratory parameters. Duration of treatment: 17 days ICD codes: P23 Congenital pneumonia P23.0 Viral congenital pneumonia P23.1
  7. Question 25 Pneumonia
    - An acute infectious and inflammatory disease of the pulmonary parenchyma with the involvement of all structural elements, mainly the respiratory departments of the lungs. The concept of "pneumonia" does not include lung lesions caused by physical and chemical factors, diseases caused by vascular and allergic changes, bronchitis, bronchiolitis and diffuse pulmonary fibrosis. Classification
  8. Acute pneumonia
    1. What is the synonym for croupous pneumonia: a) bronchopneumonia b) focal c) focal confluent d) segmental e) lobar Correct answer: e 2. What is the stage of croupous pneumonia: a) carnification b) abscessing c) red wards a) fibrinoid swelling Correct answer: in 3. The composition of the exudate in the 3 stages of croupous pneumonia: a) fibrin, red blood cells b) fibrin,
  9. PNEUMONIA
    In domestic pediatrics, pneumonia is defined as an acute infectious disease of the pulmonary parenchyma diagnosed by respiratory distress syndrome and / or physical data, as well as infiltrative changes in the radiograph. The presence of radiological signs is the "gold standard" of diagnosis, since it allows not to attribute viral lesions of the lower respiratory tract to pneumonia
  10. Acute pneumonia
    Pneumonia is understood as an infectious disease characterized by focal lesions of the respiratory parts of the lungs with intra-alveolar exudation and accompanied by a febrile reaction and intoxication. The following types of pneumonia are distinguished: a) community-acquired (community-acquired), b) nosocomial (hospital, nasocomial), c) aspiration and abscessed, d) pneumonia with immunodeficiency
  11. PNEUMONIA
    Pneumonia is an acute infectious disease characterized by focal lesions of the respiratory parts of the lungs with intra-alveolar exudation, detected by objective and x-ray examination, expressed to varying degrees by a febrile reaction and intoxication. Clinically significant is the division of pneumonia into community-acquired and nosocomial (hospital,
  12. Pneumonia
    Pneumonia is an inflammatory process in the tissues of the lung that occurs as an independent disease or as a manifestation or complication of a disease. Untreated pneumonia leads to death. The severity of the disease depends on the type of infection, the age of the patient, general health. Pathophysiology • Elderly and weakened people most often suffer from pneumonia. • Bacterial pneumonia: - infection
  13. Pneumonia
    Pneumonia - inflammatory processes in the lungs as an independent disease or complications of other diseases. Classification (K.A.Sotnikova): intrauterine and neonatal pneumonia, bacterial, viral, parasitic, fungal, specific infections and mixed, bronchopneumonia, small and large focal, confluent, mono-and polisegmental, interstitial and abscess, mild, medium
  14. PNEUMONIA
    Acute pneumonia is an inflammatory process that encompasses all lung tissue. The incidence rate is 3 - 4 per 1000 people (0.4%). The process affects the bronchioles, interstitial tissue, vessels and nerves are always involved. Patients should not die of acute pneumonia as the main disease with adequate therapy, but acute pneumonia may be concomitant with a number of
  15. Inflammation of the lungs (pneumonia)
    Pneumonia in children is an acute infectious and inflammatory process of various etiologies. The mechanisms of the development of the disease are associated with a predominant lesion of the respiratory lungs. The respiratory sections of the lungs are the anatomical structures located behind the terminal bronchi - respiratory, alveolar passages and alveoli. The incidence of pneumonia in children in the first year of life
  16. Pneumonia in children
    The article “Pneumonia” is located in Section 4 “Emergency conditions for respiratory diseases”. Pneumonia in children is an acute infectious disease of the pulmonary parenchyma diagnosed by respiratory distress syndrome and / or physical data, as well as by infiltrative or focal changes in the radiograph. CLASSIFICATION ¦ According to the conditions of infection, pneumonia is divided into
  17. SECONDARY ACUTE PNEUMONIA
    HYPOSTATIC PNEUMONIA - focal pneumonia that occurs with prolonged stagnation of blood in the pulmonary circulation, developing against a background of heart disease or other chronic pathological processes that cause patients to stay in bed for a long time. The clinic of such pneumonia is characterized by a sluggish course. The onset of the disease is hardly noticeable, without any particular complaints. Prevails
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