Общая реаниматология (Jun 2008)

Clinical and Morphological Features of Nosocomial Pneumonia in Patients with Peritonitis

  • T. V. Smelaya,
  • V. V. Moroz,
  • A. M Golubev,
  • G. V. Azarov,
  • A. N., Kuzovlev,
  • L. A. Marsova,
  • L. R. Gadzhiyeva,
  • Yu. G. Tikhonov,
  • A. N. Veligan

DOI
https://doi.org/10.15360/1813-9779-2008-3-59
Journal volume & issue
Vol. 4, no. 3

Abstract

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Objective: to reveal the clinical and morphological features of nosocomial pneumonia (NP) in patients with generalized peritonitis and to define its role in tanatogenesis. Subjects and methods. The study was based on an analysis of 94 patients with generalized peritonitis and 11 autopsy protocols. Results. The postoperative period was complicated by the development of NP in 46 (48.9%) patients with generalized peritonitis, including ventilator-associated pneumonia (VAP) in 28 (60.9%) cases. Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) were diagnosed in 11 and 2 patients, respectively. ALI was followed by NP in 3 patients and revealed in the presence of the latter in 8. VAP antedated ARDS in both cases. In the group of patients with generalized peritonitis, overall and attributive mortality rates were 12.8 and 3.2%, respectively. Conclusion. The present study and the analysis of the results of autopsy protocols have revealed that NP in generalized peritonitis may be both a cause and an effect of ALI, thus playing a significant role in tanatogenesis. Key words: nosocomial pneumonia, acute lung injury, pulmonary edema, peritonitis.