Pediatric surgical sepsis: diagnostics and intensive therapy

Authors

  • Elmira Satvaldieva Tashkent Pediatric Medical Institute, Uzbekistan https://orcid.org/0000-0002-8448-2670
  • Gulchehra Ashurova Tashkent Pediatric Medical Institute, Uzbekistan
  • Otabek Fayziev Tashkent Pediatric Medical Institute, Uzbekistan
  • Abdumalik Djalilov Clinic of Tashkent Pediatric Medical Institute, Uzbekistan

DOI:

https://doi.org/10.15587/2519-4798.2021.250239

Keywords:

pediatric sepsis, balanced crystalloids, respiratory support, septic shock

Abstract

The aim: Optimization of diagnostics and schemes of pathogenetic intensive therapy of surgical sepsis in children based on clinical and laboratory criteria and bacteriological monitoring.

Materials and methods: The research period is 2018-2020. The object of the study (n=73) – children with surgical pathology (widespread peritonitis, bacterial destruction of the lungs, post-traumatic brain hematomas, abdominal trauma, etc.). Research methods: microbiological monitoring to determine the sensitivity of the microorganism to antibiotics was carried out before and at the stages of treatment (sputum, urine, wound, bronchoalveolar lavage, tracheal aspirate, blood, contents from drainages, wound surface). Determination of the sensitivity of the isolated strains to antibiotics was carried out by the disk-diffusion method. To determine predictors of sepsis in surgical patients, clinical (mean arterial pressure (mAP), heart rate (HR), respiratory rate (RR), SpO2, etc. and laboratory parameters on days 1–2 (up to 48 hours) of sepsis identification, days 4 and 8 of intensive therapy. Procalcitonin was determined by immunofluorescence on a Triage® MeterPro analyzer (Biosite Diagnostics, USA). Blood gases and electrolytes were analyzed using a Stat Profile CCX analyzer (Nova Biomedical, USA).

Results: studies have shown the effectiveness of complex intensive care in 86.3 % of cases. Mortality was found in 13.7 % of cases. Patients with severe surgical pathology died: widespread peritonitis, severe TBI + coma with irreversible neurological disorders, urosepsis against the background of chronic renal failure, after repeated surgical interventions, due to the development of refractory septic shock (SS).

Conclusions. Early diagnosis of sepsis, rational early ABT under the control of microbiological monitoring, non-aggressive infusion therapy with early prescription of vasopressors (SS) with constant monitoring of the child's main life support organs contribute to an improvement in sepsis outcomes and a decrease in mortality

Author Biographies

Elmira Satvaldieva, Tashkent Pediatric Medical Institute

Doctor of Medical Sciences, Professor-Head

Department of Anesthesiology and Reanimatology Pediatric Anesthesiology and Reanimatology

Gulchehra Ashurova, Tashkent Pediatric Medical Institute

Assistant

Department of Anesthesiology and Reanimatology Pediatric Anesthesiology and Reanimatology

Otabek Fayziev, Tashkent Pediatric Medical Institute

Assistant

Department of Anesthesiology and Reanimatology, Pediatric Anesthesiology and Reanimatology

Abdumalik Djalilov, Clinic of Tashkent Pediatric Medical Institute

Chief Physician

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Published

2021-11-30

How to Cite

Satvaldieva, E., Ashurova, G., Fayziev, O., & Djalilov, A. (2021). Pediatric surgical sepsis: diagnostics and intensive therapy. ScienceRise: Medical Science, (6(45), 34–42. https://doi.org/10.15587/2519-4798.2021.250239

Issue

No. 6(45) (2021)

Section

Medical Science

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Copyright (c) 2021 Elmira Satvaldieva, Gulchehra Ashurova, Otabek Fayziev, Abdumalik Djalilov

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