Клінічна та профілактична медицина (Mar 2025)
PECULIARITIES OF OXYGEN TRANSPORT FUNCTION IN CHILDREN WITH ACUTE RESPIRATORY DISEASES
Abstract
Introduction. Acute inflammatory diseases of the lower respiratory tract in children are considered to be the most common cause of high hospitalization rates. In their pathogenesis, disorders of the cardiovascular system are recorded, especially under hypoxic conditions. Even in cases of mild and moderate course of acute pneumonia and bronchitis, cardiovascular disorders are observed, especially from microcirculation (MC) and associated with instability of blood oxygen saturation. Aim. To evaluate the peculiarities of the MC and peripheral gas exchange indicators in children with acute bronchitis (AB) and community-acquired pneumonia (CAP) with the assessment of increased risk of severe course of disease. Materials and methods. The data of the biomicroscopy of the finger nail bed vessels, the level of the capillary blood oxygen saturation (SaO2) from pulsoxymetry and capillary refill test obtained in 60 school-age children (30 with CAP and 30 with AB) compared to the data of 30 children of the control group) were assessed. The obtained results were analyzed statistically using parametric and nonparametric methods. Results. Hospitalized children were examined during the early convalescence with stabilized general conditions and normalization of body temperature. In patients’ blood oxygen saturation did not reach critical levels, but were significantly lower than in the control group (CAP – 96.6±0.41%, AB – 96.6±0.44%, control – 97.7±0.19%, p < 0.05). In biomicroscopy, a number of changes were recorded, such as arterioles and capillary cramps, reducing the number of functioning capillary loops, tortuosity and red cells adhesion in venules. These changes were registered in a greater extent in children with CAP and slight lower – in children with AB. Cluster analysis of MC and SaO2 indicators shows a relationship between them based on slowed down peripheral blood flow, probably due to endothelial dysfunction. Conclusions. In children with CAP and AB, even in period of early convalescence, vascular disorders of the MC bed in the form of spasms of arterioles and capillaries, reducing the number of functioning capillary loops, tortuosity of venules could be present. These changes are recorded in combination with the unstable blood oxygen saturation, which indicates damage to the MC vessels in the course of acute lower respiratory tract diseases in children. The presence of such changes makes it possible to predict the risk of severe CAP.
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