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THE COURSE OF PNEUMONIA IN THE BACKGROUND OF CONGENITAL HEART
DEFECTS IN YOUNG CHILDREN IN THE SOUTHERN ARAL REGION
Babadjanova Faniya Rashidovna
Urgench branch of Tashkent Medical Academy
Department of hospital and polyclinic pediatrics
Republic of Uzbekistan, Urgench
Relevance:
Currently, frequent respiratory infections in patients with congenital heart defects
(UPU) often lead to the development of pneumonia against the background of chronic pulmonary
blood or chronic hypoxia. Pneumonia in malformations with increased pulmonary blood flow occur
in the first year of life, differ in protracted flow, and are difficult to treat.
Research objective
: Study of the characteristics of the course of pneumonia against the background
of congenital heart defects (CHD) in young children and optimization of treatment.
Materials and methods:
22 children with different CHD treated in the Children’s regional
multidisciplinary medical center (CRMMC) in 2020-2021, 10 of them (45.5%) boys and 12 (54.5%)
girls. The average age is 1.2. All children underwent routine examination (hemogram, urogram,
coprogram). The diagnosis of CHD was verified based on echocardiography (EhKG) results. All
children with CHD admitted to the CRMMC were registered with a cardiac surgeon. The reason
for admission to the CRMMC was a sharp deterioration in the condition of the child, which was
accompanied by shortness of breath, severe anxiety, sinking of the skin, increased div
temperature.
Results and discussion
: Among the children, we examined with CHD with the ventricular septum
defect (VSD) there were 9 (41%), with the atrial septal defect (ASD) - 1 (4.5%), with a tetralogy of
Fallot - 3 (13.6%). The remaining 9 (41%) patients showed severe combined defects (transposition
of main vessels, double divergence of main vessels, atresia of the tricuspid valve, VSD, ASD,
pulmonary artery stenosis, atrioventricular communications, single ventricle in different
combinations). All admitted children have pneumonia of various morphological forms. Children
were admitted in serious condition, mainly due to respiratory and cardiovascular failure. Of the
clinical manifestations in children, dyspnea of a mixed nature, cough, an increase in div
temperature from subfebrile to febrile numbers, anxiety, remote oral wheezing, weakness, refusal
to eat. During an objective examination, seeding of the skin was noted, increased respiration with
retraction of the intercosts. In the lungs, there was stiff breathing; scattered dry and fine-bubbled
wet wheezing on both sides, with extensive lung damage, weakened breathing was listened to. From
the cardiovascular system, noises of various nature (systolic, diastolic, machine noise) were heard.
In the general blood test, neutrocytosis by was mainly noted - microxyphil clear averaged 57.8%,
the hemoglobin level was raised to 121.3 g/l, which, in our opinion, is associated with the div's
compensatory response to chronic hypoxia. White blood cells averaged 7.8x109/L, the remaining
indicators were within the age norm. In a bacteriological study, mainly hospital strains such as
Staphylococcus aureus (18.6%), Klebsiella pneumoniae (20.4%), Pseudomonas aeroginosa
(15.8%), Streptococcus viridans (13.2%) and It should be noted that these children had pneumonia
several times and were treated outpatient. The length of stay in the hospital averaged 8.7 days. In
the treatment of antibacterial drugs, mainly cephalosporins of the 2nd-3rd generation,
aminoglycosides (amikacin) in combination were used. In the presence of pulmonary hypertension,
preparations from the group of inhibitors of the angiotensin converting enzyme - captopril were
used, veroshpyrone was used for unloading from diuretics, since it preserves potassium, digoxin
and thiotriosoline were prescribed from cardiotropic drugs to improve metabolism in the
myocardium.
Conclusions
: A peculiarity of the clinic of pneumonia in CHD is the severe course and rapid
development of various complications. When clinical symptoms of respiratory tract damage appear,
children with CHD should be hospitalized in a hospital to avoid complications. The optimization
of treatment, in our opinion, should be based on the timely use of pathogenetic complex therapy,
including cupping of circulatory insufficiency, etiotropic antibacterial, cardioprotective drugs.
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Children with CHD need to carry out general strengthening and rehabilitation events to achieve the
phase of relative compensation for clinical manifestations.
References
1.
Агзамова, Ш. А., Ш. А. Абдуразакова, and Д. Ж. Шухратова. "Значение уровня
эритропоэтина в диагностике и мониторировании анемии у детей." МАТЕРИ И
РЕБЕНКА (2016).
2.
Agzamova, Shoira. "Value of heart rate variability parameters in prognosis of intrauterine
infection of infants with cytomegalovirus." Medical and Health Science Journal 4 (2010): 24-
30.
