The development of complications of community-acquired pneumonia of a severe course against the background of parenteral poisoning with a mixture of narcotic substances


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Abstract

Doctors of the clinic of military field therapy of the Military Medical Academy named after S.M. Kirov, the experience of successful treatment of community-acquired pneumonia of a severe course with the development of complications against the background of parenteral poisoning with a mixture of narcotic substances in a young patient was obtained. An important feature in the treatment tactics of this patient was the impossibility of antidote therapy with naloxone (a competitive opioid receptor antagonist) due to the presence of signs of respiratory failure, hypoxic and tissue hypoxia. As a result of the systemic treatment in the young patient, it was possible to arrest a significant septic process and multiple organ disorders of vital functions that arose due to severe endotoxic damage. An important factor in ensuring the survival of patients with severe pneumonia against a background of immune depression due to the use of toxic substances is the rational selection of an antibacterial drug or combinations of antibiotic therapy, constant monitoring of vital functions with prompt correction of emerging disorders, as well as the need to use modern high-tech treatment methods. This example clearly shows the need for urgent, systematic and complex intensive care in a number of manipulations performed in people with complications of community-acquired pneumonia, suffering from drug addiction. In addition, it is important to minimize the time from the detection of a poisoned person to the start of emergency measures, as well as their further evacuation to the stage of providing qualified and specialized medical care. Thus, modern medicine continues to face an extremely urgent problem of drug use by the population. A significant number of people with drug dependence syndrome do not seek medical help for various reasons, continuing to use illegal drugs.

About the authors

I. N. Gayvoronskiy

Military medical academy of S.M. Kirov

Author for correspondence.
Email: vmeda-nio@mil.ru
Russian Federation, Saint Petersburg

Yu. Sh Khalimov

Military medical academy of S.M. Kirov

Email: vmeda-nio@mil.ru
Russian Federation, Saint Petersburg

S. V. Gayduk

Military medical academy of S.M. Kirov

Email: vmeda-nio@mil.ru
Russian Federation, Saint Petersburg

T. V. Lyanginen

Military medical academy of S.M. Kirov

Email: vmeda-nio@mil.ru
Russian Federation, Saint Petersburg

A. S. Partsernyak

Military medical academy of S.M. Kirov

Email: vmeda-nio@mil.ru
Russian Federation, Saint Petersburg

R. I. Litvinenko

Military medical academy of S.M. Kirov

Email: vmeda-nio@mil.ru
Russian Federation, Saint Petersburg

References

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1. JATS XML
2. Fig. 1. Dynamics of indicators of general clinical blood test

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3. Fig. 2. Dynamics of indicators of biochemical blood test

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4. Fig. 3. Dynamics of indicators of coagulogram

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5. Fig. 4. Dynamics of indicators of blood gas composition against the background of mechanical ventilation with FiO2 100%

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6. Fig. 5. ECG upon admission to the hospital

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7. Fig. 6. X-ray of the chest organs in the supine position upon admission to the hospital

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8. Fig. 7. Dynamics of sepsis markers and SOFA scores against the background of ongoing antibiotic therapy

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9. Fig. 8. Chest X-ray at discharge

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Copyright (c) 2020 Gayvoronskiy I.N., Khalimov Y.S., Gayduk S.V., Lyanginen T.V., Partsernyak A.S., Litvinenko R.I.

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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