PERINATOLOGIYA I PEDIATRIYA. 2014. 2(58):51-53; doi 10.15574/PP.2014.58.51 
 

Case of successful treatment of pneumococcal sepsis in a child of early age in the setting of complicated pneumonia 
 

Semkovych Ya.V.

State Higher Educational Institution “Ivano-Frankivsk National Medical University”, Ivano-Frankivsk, Ukraine 
 

The child who stayed in the anesthesiology and intensive therapy unit of regional children’s clinical hospital of Ivano-Frankivsk has been treated on the occasion of severe sepsis. In the time of hospitalization the condition of the child was critical due to breathing disorder (respiratory distress of type II by obstructive and constrictive, and restrictive type in the setting of pneumonia with progressive exudative pleuritis), endointoxication, anemic, hypoproteinemic and dyselectrolytemic syndromes. Due to progression of respiratory distress by restrictive type, right pleural cavity of the child was drained (Bulau drain). Taking into account the increase of respiratory distress and renal failure, hemorrhagic, anemic syndromes, and brain disorder, intubation of trachea and artificial respiration were carried out. Due to multiple organ dysfunction, the peritoneal dialysis was conducted on the third day of staying in the anesthesiology and intensive therapy unit. To correct anemic, hypoalbuminemic syndromes washed erythrocytes and fresh-frozen plasma were transfused. Aiming at immunoglobulin replacement, human intravascular immunoglobulin was injected. Because of progression of purulent lung component therapeutic bronchoscopy was carried out.

On the eighth day of treatment the tracheal extubation was conducted and the drain was removed from the pleural cavity. On the twentieth day of treatment in the anesthesiology and intensive therapy unit the child was transferred to Pediatrics. On the fourteenth day of staying in Pediatrics and on the thirty-third day – in in-patient department due to satisfactory condition the child was discharged. 
 

Key words: sepsis, pneumonia, children. 
 

REFERENCES

1.Про затвердження клінічних Протоколів надання медичної допомоги при невідкладних станах у дітей на шпитальному і до шпитальному етапах: наказ МОЗ України від 31.08.2004 р. № 437 [Електронний документ]. – Режим доступу: http: //www.moz.gov.ua. – Назва з екрана.

2.Degoricija V, Sharma M, Legac A. 2006. Survival analysis of 314 episodes of sepsis in medical intensive care unit in university hospital: impact of intensive care performance and antimicrobial therapy. Croatia Medical Journal. 47(3): 385–397. PMid:16758516 PMCid:PMC2080418

3.Kumar A, Roberts D, Wood KE. et al. 2006. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Care Med. 34(6): 1589–1596. http://dx.doi.org/10.1097/01.CCM.0000217961.75225.E9 PMid:16625125

4.Shapiro NI, Howell MD, Talmor D. et al. 2006. Implementation and outcomes of the Multiple Urgent Sepsis Therapies (MUST) protocol. Crit. Care Med. 34(4): 1025–1032. http://dx.doi.org/10.1097/01.CCM.0000206104.18647.A8 PMid:16484890

5. Brun-Buisson C, Doyon F, Carlet J. et al. 1995. Incidence, risk factors, and outcome of severe sepsis and septic shock in adults. A multicenter prospective study in intensive care units. French ICU Group for Severe Sepsis. JAMA. 274(12): 968–974.

6.Kortgen A, Niederprum P, Bauer M. 2006. Implementation of an evidence-based «standard operating procedure» and outcome in septic shock. Crit. Care Med. 34(4): 943–949. http://dx.doi.org/10.1097/01.CCM.0000206112.32673.D4 PMid:16484902

7.Wang HE, Shapiro NI, Angus DC. et al. 2007. National estimates of severe sepsis in United States emergency departments. Crit. Care Med. 35(8): 1928–1936. http://dx.doi.org/10.1097/01.CCM.0000277043.85378.C1 PMid:17581480

8. Soshitova NP, Karamzin SS, Fadeeva OA. et al. 2012. Predicting prothrombotic tendencies in sepsis using spatial clot growth dynamics. Blood Coagul Fibrinolysis. 23(6): 498–507. http://dx.doi.org/10.1097/MBC.0b013e328352e90e PMid:22688554

9. Nguyen HB, Rivers EP, Abrahamian FM. et al. 2006. Severe sepsis and septic shock: review of the literature and emergency department management guidelines. Ann. Emerg. Med. 48(1): 28–54. http://dx.doi.org/10.1016/j.annemergmed.2006.02.015 PMid:16781920

10. Dellinger RP, Levy MM, Carlet JM. et al. 2008. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Crit. Care Med. 36(1): 296–327. http://dx.doi.org/10.1097/01.CCM.0000298158.12101.41 PMid:18158437

11. Shapiro N, Howell MD, Bates DW. et al. 2006. The association of sepsis syndrome and organ dysfunction with mortality in emergency department patients with suspected infection. Ann. Emerg. Med. 48(5): 583–590. http://dx.doi.org/10.1016/j.annemergmed.2006.07.007 PMid:17052559

12. Trzeciak S, Rivers EP. 2005. Clinical manifestations of disordered microcirculatory perfusion in severe sepsis. Crit. Care. 9 (Suppl 4): 20–26.http://dx.doi.org/10.1186/cc3564 http://dx.doi.org/10.1186/cc3083 http://dx.doi.org/10.1186/cc3798 http://dx.doi.org/10.1186/cc3744 PMid:16168070 PMCid:PMC3226160