Year 2024 Vol. 32 No 1

SCIENTIFIC PUBLICATIONS

M.F. CHERKASOV, I.I. BABICH, Y.N. MELNIKOV, I.O. BAGNOVSKY

CURRENT ASPECTS OF TREATMENT OF ACUTE PURULENT DESTRUCTIVE PNEUMONIA IN CHILDREN

Federal State Budgetary Educational Establishment of Higher Education "Rostov State Medical University" of the Ministry of Health of the Russian Federation,
State Budgetary Institution of the Rostov Region "Regional Children's Clinical Hospital", Rostov-on-Don,
Russian Federation

Acute purulent destructive pneumonia (APDP) is focal or confluent pneumonia of various etiologies, characterized by necrosis and purulent melting of lung tissue with the addition of pleural complications. The severity of the disease is due to a combination of respiratory and heart failure against the background of a pronounced intoxication syndrome, and a high mortality rate (2 - 13%). In children of the first year of life, mortality can reach from 22 to 51%. At the same time, hospitalization periods, according to various literature sources, can vary from 15 to 47 bed days. The study analyzed domestic and foreign literature data on surgical treatment of destructive pneumonia in children, published over the past 10 years. The search was carried out using keywords in such search engines as: eLibrary, PubMed, Medline, Scopus, Google Scolar. The article presents a review of 49 literature sources, which contains studies on the epidemiology, classification, diagnosis and treatment of destructive pneumonia in children. The work separately emphasizes the importance of early thoracoscopy in children with pulmonary-pleural forms of destructive pneumonia. The problem of treating destructive pneumonia in children currently remains extremely relevant. Despite the development of medical technologies and the introduction of new treatment methods, mortality in childhood remains at a fairly high level. The length of hospitalization due to the development of pulmonary-pleural complications can reach 47 bed-days. The issue of radical relief of bronchopleural fistulas, according to the authors remains open and requires the development of new treatment methods.

Keywords: destructive pneumonia, bronchopleural fistula, thoracoscopy, children
p. 61-69 of the original issue
References
  1. Chuchalin AG. Vnebol’nichnaja pnevmonija u detej. Klinicheskie rekomendacii. Ì. 2015;9-10. (In Russ.)
  2. Beaucoté V, Plantefève G, Tirolien JA et al. Lung Abscess in Critically Ill Coronavirus Disease 2019 Patients With Ventilator-Associated Pneumonia: A French Monocenter Retrospective Study. Crit Care Explor. 2021; 3(7): e0482. doi: 10.1097/CCE.0000000000000482.
  3. Blonz G, Kouatchet A, Chudeau N et al. Epidemiology and microbiology of ventilator-associated pneumonia in COVID-19 patients: a multicenter retrospective study in 188 patients in an un-inundated French region. Crit Care. 2021; 25(1): 72. doi: 10.1186/s13054-021-03493-w.
  4. Spencer DA, Thomas MF. Necrotizing pneumonia in children. Pediatr Respir Rev. 2014; 15:240–5.
  5. Pandey P, Agarwal S, Rajkumar. Lung Pathology in COVID-19: A Systematic Review. Int J Appl Basic Med Res. 2020; 10(4): 226-233. doi: 10.4103/ijabmr.IJABMR_381_20.
  6. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y, Li H, Wu X, Xu J, Tu S, Zhang Y, Chen H, Cao B. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395(10229): 1054-1062. doi: 10.1016/S0140-6736 (20)30566-3.
  7. Sgambatti S, Minamisava R, Bierrenbach AL. Early impact of 10-valent pneumococcal conjugate vaccine in childhood pneumonia hospitalizations using primary data from an active population-based surveillance.Vaccine. 2016; 34:663–70. doi: 10.1016/j.vaccine.2015.12.007
  8. Mashkov AE, Elin LM, Slesarev VV, Filjushkin JuN. Rol’ superinfekcii v jetiologicheskoj strukture ostroj gnojnoj destruktivnoj pnevmonii u detej. Detskaja hirurgija. 2018; 22 ( 5): 241-245. doi: 10.18821/1560-9510-2018-22-5-241-245 (In Russ.)
  9. Beloborodova NV, Tarakanov VA, Barova NK. Analiz prichin destruktivnyh pnevmonij u detej i vozmozhnosti optimizacii antimikrobnoj terapii. Pediatrija Zhur im Speranskogo. 2016;95(2):66-71. (In Russ.)
  10. Tong SY, Davis JS, Eichenberger E, Holland TL, Fowler VG. Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management. Clin Microbiol Rev. 2015; 28:603–61. doi: 10.1128/CMR.00134–14
  11. De Schutter I, Vergison A, Tuerlinckx D. Pneumococcal aetiology and serotype distribution in paediatriccommunityacquired pneumonia. PLoS One. 2014; 9: e89013. doi: 10.1371/journal.pone.0089013
  12. Zajceva OV, Zajceva SV, Lokshina JeJe, Haspekov DV, Tkachenko NV, Sholohova NA, Kulikova EV, Simanovskaja HJu, Tomilova AJu, Barkinhoev AT, Beljaeva TJu. Vnebol’nichnye pnevmonii u detej v jepohu pandemii SOVID-19. Chto izmenilos’? Med Sovet. 2021;(1):214–19. doi: 10.21518/2079-701X-2021-1-214-219. (In Russ.)
  13. Zajceva OV, Tolstova EM, Haspekov DV, Tkachenko NV, Sholohova NA, Simonovskaja HJu, Beljaeva TJu. O patogeneze destruktivnoj pnevmonii v period COVID-19: klinicheskoe nabljudenie. Pul’monologija. 2023;33(1):92–101. doi: 10.18093/0869-0189-2023-33-1-92-101 (In Russ.)
  14. Zajrat’janc OV , Maljavin AG, Samsonova MV, Chernjaev AL, Mishnev OD, Mihaleva LM, Krupnov NM, Kalinin DV. Patomorfologicheskie izmenenija v legkih pri COVID-19: klinicheskie i terapevticheskie paralleli. Terapija. 2020;6(5):35-46. doi: 10.18565/therapy.2020.5.35-46 (In Russ.)
  15. Tjurin IE, Strutynskaja AD. Vizualizacija izmenenij v legkih pri koronavirusnoj infekcii (obzor literatury i sobstvennye dannye). Pul’monologija. 2020; 30(5):658-70. doi: 10.18093/0869-0189-2020-30-5-658-670. (In Russ.)
  16. Zabozlaev FG, Kravchenko JeV, Galljamov A R. Patologicheskaja anatomija legkih pri novoj koronavirusnoj infekcii (COVID-19). Predvaritel’nyj analiz autopsijnyh issledovanij. Klin Praktika. 2020;11(2):21-37. doi: 10.17816/ clinpract34849. (In Russ.)
  17. Vecherkin VA, Toma DA, Pticyn VA, Korjashkin PV. Destruktivnye pnevmonii u detej. Ross Vestn Det Hirurgii Anesteziologii i Reanimatologii. 2019;9(3):108–115. doi: 10.30946/2219-4061-2019-9-3-108-115 (In Russ.)
  18. Chatha N, Fortin D, Bosma KJ. Management of necrotizing pneumonia and pulmonary gangrene: a case series and review of the literature. Can Respir J. 2014;21:239–45. doi: 10.1155/2014/864159
  19. Thomas MF, Wort A, Spencer DA. Management and complications of pneumonia. Pediatr Child Health. 2014;25:172–78. doi: 10.1016/j.paed.2014.11.004
  20. Torrses A, Lee N, Cilloniz C, Vila J, Van der Eerden M. Laboratory diagnosis of pneumonia in the molecular age. Eur Respir J. 2016;48:1764–78. doi: 10.1183/13993003.01144–2016
  21. Murdoch DR. How to best determine causative pathogens in pneumonia. Pneumonia. 2016;8:1. doi: 10.1186/s41479–016–0004-z
  22. Shaughnessy EE, Stalets EL, Shah SS. Community-acquired pneumonia in the post 13-valent pneumococcal conjugate vaccine era. Curr Opin Pediatr. 2016;28:786–793. doi: 10.1097/MOP.0000000000000428
  23. Almaramhy HH, Allama AM. Indicators for surgical intervention in thoracic empyema in children. Saudi Med J. 2015;36(9):1061-1066. doi: 10.15537/smj.2015.9.11326
  24. Semernik OE, Lebedenko AA, Tjurina EB, Luspikajan SH. Analiz techenija vnebol’nichnyh pnevmonij u detej g. Rostova-na-Donu. Sechenovs Vestn. 2019;10(1):52-56. doi: 10.26442/22187332.2019.1.52-56 (In Russ.).
  25. Haspekov DV, Ol’hova EB, Topilin OG, Safin DA, Tkachenko NV, Sokolov JuJu. Sovremennye metody diagnostiki i lechenija destruktivnoj pnevmonii u detej. Ross Vestn Detskoj Hirurgii Fnesteziologii i Reanimatologii. 2015;5(2): 7–12. (In Russ.).
  26. Barskaja MA, Terehina MI, Kuz’min AI, Munin AG, Seregina TN, Markova MN, Zebrova TA. Differencirovannyj podhod v taktike lechenija legochno- plevral’nyh form destruktivnyh pnevmonij u detej. Mezhdunar Zhurnal Prikladnyh i Fundam Issledovanij, 2015;12: 1042-1045. (In Russ.).
  27. Tolstova EM, Zajceva OV, Besedina MV, Haspekov DV, Beljaeva TJu. Sovremennyj vzgljad na problemu destruktivnyh pnevmonij u detej. Medicinskij Sovet. 2023;17(1):28–33. doi: 10.21518/ms2023-025
  28. Torrses A, Lee N, Cilloniz C, Vila J, Van der Eerden M. Laboratory diagnosis of pneumonia in the molecular age. Eur Respir J. 2016;48:1764–78. doi: 10.1183/13993003.01144–2016
  29. Lai SH, Wong KS, Liao SL. Value of lung ultrasonography in the diagnosis and outcome prediction of pediatric community-acquired pneumonia with necrotizing change. PLoS One . 2015;10(6): e0130082.
  30. Pinchuk TP, Jasnogorodskij OO, Gur’janova JuV, Taldykin MV, Kachikin AS, Katanje JuA. Diagnosticheskaja i lechebnaja bronhoskopija u pacientov s gnojno-destruktivnymi zabolevanijami legkih. Hirurgija. Zhurnal im NI Pirogova. 2017;8:33–39. EDN: ZCPGLP doi: 10.17116/hirurgia2017833-39. (In Russ.).
  31. Drobjazgin EA, Chikinev JuV, Sudovyh IE. Jendoskopicheskaja klapannaja bronhoblokacija pri lechenii bronhoplevral’nyh svishhej i utechki vozduha. Hirurgija. Zhurnal im NI Pirogova. 2020; 5: 49–57. doi: 10.17116/hirurgia202005149. (In Russ.).
  32. Ivchenko DR, Kovalev AS, Akimov AV, Nikolaev KN, Judenkov SN, Emel’janov IN, Golubov EA, Chevychelov SV. Hirurgicheskie oslozhnenija u bol’nyh COVID-19. Hirurgija. Zhurnal im NI Pirogova. 2022;8:69–74. doi: 10.17116/hirurgia202208169 (In Russ.).
  33. Malofej AM, Ablicov AJu, Orlov SS. Osobennosti lechenija plevrolegochnyh oslozhnenij kovid-associirovannyh pnevmonij, Vestn Nac-Hirurgicheskogo Centra im. N.I. Pirogova. 2022; 17(4): 75-80. Doi: 10.25881/20728255_2022_17_4_2_75. (In Russ.).
  34. Kalenchic TI, Kabak SL, Primak SV, Shirinaliev NM. Abscess legkogo kak oslozhnenie COVID-19 pnevmonii: klinicheskij sluchaj . Tuberkulez i Bolezni legkih. 2021;99(12):7-13. doi: 10.21292/2075-1230-2021- 99-12-7-12. (In Russ.).
  35. Timerbulatov MV, Zabelin MV, Timerbulatov Sh.V. Posleoperacionnye oslozhnenija u inficirovannyh COVID-19 pacientov (obzor literatury). Vest Hirurgii im I I Grekova. 2021;180(1):118-122. doi: 10.24884/0042-4625-2021-180-1-118-122 (In Russ.).
  36. Slepcov AA, Savvina VA, Jerdyneev TJe, Varfolomeev AR, Nikolaev VN, Zuev AL, Kolmogorov VV. Torakoskopicheskaja sanacija plevral’noj polosti pri gnojno-vospalitel’nyh zabolevanijah legkih u detej. Ross Vestn Det Hirurgii Anesteziologii i Reanimatologii. 2015;5(1):74-77. (In Russ.).
  37. Ionov PM, El’kin AV, Dejnega IV, Jakovlev GA. Klinika, diagnostika, lechenie i ishody ostryh abscessov ljogkih u bol’nyh s VICh- infekciej. Vest Hirurgii im I I Grekova. 2020;179(3):69-74. doi: 10.24884/0042-4625-2020-179-3-69-74. (In Russ.).
  38. Pavlov AA, Sergeeva AI, Zol’nikov ZI. Torakoskopicheskaja sanacija s ul’trazvukovym kontrolem u detej s fibrinotoraksom. Ross Vestn Det Hirurgii Anesteziologii i Reanimatologii. 2021; 11(3): 367–374. doi: 10.17816/psaic955. (In Russ.).
  39. Belov SA, Cyleva JuI, Grigorjuk AA. Lechenie spontannogo pnevmotoraksa u detej. Detskaja hirurgija. Zhurnal im Ju F Isakova. 2022;26(5):287–90. doi: 10.55308/1560-9510-2022-26-5-287-290. (In Russ.).
  40. Cyleva JuI, Belov SA, Grigorjuk AA, Kozlov JuV. Lechenie rebenka 4 let s destruktivnoj pnevmoniej. Det Hirurgija. 2023; 27(6): 470-477. doi: 10.17816/ps596. (In Russ.).
  41. Mustakimov BH, Rostovcev NM. Lechenie spontannogo gemopnevmotoraksa u rebjonka 16 let. Det Hirurgija. 2023; 27(5): 367-369. doi: 10.55308/1560-9510-2023-27-5-367-369. (In Russ.).
  42. Cyleva JuI, Belov SA, Shatoba EV, Jurkina MV. Hirurgicheskoe lechenie spontannogo pnevmotoraksa na fone plevropul’monal’noj blastomy u devochki 2 let. Det Hirurgija. 2021; 25 (5): 326-329. doi: 10.55308/1560-9510-2021-25-5-326-329. (In Russ.).
  43. Teljashov AD, Galljamov JeA, Hrupkin VI. Metody lechenija plevrolegochnyh oslozhnenij kovid- associirovannoj pnevmonii. Voenno-medicinskij zhurnal. 2021;350(10): 37-43. (In Russ.).
  44. Tarakanov VA, Barova NK, Shumlivaja TP, Goloseev KF, Kiselev AN, Kolesnikov EG, Gor’kovoj IS, Ubilava IA, Kulish TA. Sovremennye tehnologii v diagnostike i lechenii ostroj bakterial’no- destruktivnoj pnevmonii u detej. Ross Vestn Det Hirurgii Anesteziologii i Reanimatologii. 2015;5(1):50-56. (In Russ.).
  45. Barova NK. Tarakanov VA. K voprosu o vybore hirurgicheskogo metoda v lechenii legochno-plevral’nyh form bakterial’no- destruktivnoj pnevmonii u detej. Kuban Nauchnyj Vest. 2014;7(149):22-24. (In Russ.).
  46. Tarakanov VA, Barova NK, Shumlivaja TP. Sovremennye tehnologii v diagnostike i lechenii ostroj bakterial’no-destruktivnoj pnevmonii u detej. Ross Vestn Det Hirurgii Anesteziologii i Reanimatologii. 2015; 1: 50-56. (In Russ.).
  47. Bataev SM, Zurbaev NT, Molotov RS, Ignat’ev RO, Afaunov MV, Fedorov AK, Bataev AS. Pervyj opyt primenenija gidrohirurgicheskih tehnologij v lechenii detej s legochno-plevral’nymi oslozhnenijami destruktivnoj pnevmonii. Hirurgija. Zhurnal im N I Pirogova. 2019;7:15-23. doi: 10.17116/hirurgia201907115. (In Russ.).
  48. Bataev SM, Chogovadze GA, Molotov RS, Ignat’ev RO, Piljutik SF, Afaunov MV, Zurbaev NT, Fedorov AK, Firsova MV. Sovremennye tehnologii v lechenii rebenka s jempiemoj plevry posle tjazheloj katatravmy. Ross Vestn Det Hirurgii Anesteziologii i Reanimatologii. 2018;8(2):75-83. doi: 10.30946/2219-4061-2018-8-2-75-83. (In Russ.).
  49. Bataev SM, Molotov RS, Ignat’ev RO, Zurbaev NT, Afaunov MV. Gidrohirurgicheskaja sanacija plevral’noj polosti u rebenka s jempiemoj plevry na fone tjazhelogo organicheskogo porazhenija golovnogo mozga. Ross Vestn Det Hirurgii Anesteziologii i Reanimatologii. 2018;8(4):79-87 doi: 10.30946/2219–4061–2018–8–4–79–87. (In Russ.).
Address for correspondence:
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e-mail: pobzder@rambler.ru,
Melnikov Yuri Nikolaevich
Information about the authors:
Cherkasov Mikhail Fedorovich, MD, PhD, Professor, Head of the Department of Surgery No. 4, Rostov State Medical University, Rostov-on-Don, Russian Federation.
https://orcid.org/0000-0001-7587-8406
Babich Igor Ivanovich, MD, PhD, Professor, Professor, Department of Surgery No. 4, Rostov State Medical University, Rostov-on-Don, Russian Federation,
https://orcid.org/0000-0001-8282-2785
Bagnovsky Igor Olegovich, PhD, Head of the Endoscopic Department of the State Budgetary Institution RO «Regional Children’s Clinical Hospital», Rostov-on-Don, Russian Federation.
https://orcid.org/0000-0003-3672-4177
Melnikov Yuri Nikolaevich, PhD, Assistant of the Department of Surgery No. 4, Rostov State Medical of University, Rostov-on-Don, Russian Federation.
https://orcid.org/0000-0002-7035-0415
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