CLINICAL AND IMMUNOLOGICAL CHARACTERISTICS OF COMMUNITY-ACQUIRED PNEUMONIA IN CHILDREN WITH HEART FAILURE AND OPTIMIZATION OF REHABILITATION METHODS

The purpose of the updated clinical recommendations is to provide specialists, primarily anesthesiologists and resuscitators, with modern, evidence-based medicine data on the etiology, epidemiology, methods of diagnosis, treatment and prevention of severe community-acquired pneumonia in adults. In preparing this document, high-level scientific studies, systematic reviews and meta-analyses, recommendations of the Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS), European Respiratory Society/European Society of Intensive Care Medicine/European Society of Clinical Microbiology and Infectious Diseases/ Latin American Thoracic Society (ERS/ESICM/ESCMID/ALAT) and other leading professional societies.  Modern recommendations for differentiated antibiotic therapy for patients with severe community-acquired pneumonia (CAP), depending on the presence of risk factors for infection with certain microorganisms, are presented in detail, and etiotropic therapy regimens for the identified pathogen are presented. A significant section of the recommendations is devoted to respiratory therapy for TVP; a stepwise algorithm for the treatment of acute respiratory failure is formulated depending on its stage. The most effective and safe modes of invasive and non-invasive methods of respiratory support are characterized in detail. Glucocorticosteroids are named as methods of adjuvant therapy if it is impossible to stabilize hemodynamic parameters against the background of adequate hydration and vasopressor support, as well as parenteral anticoagulants to prevent thromboembolic complications. Anti-pneumococcal and anti-influenza vaccines have been proposed to prevent TVP in high-risk patients. Criteria for assessing the quality of medical care are presented...