Abstract
The acute destructive pneumonias (ADP) occupy up to 80% of the total number of pneumonias. They require constant improvement of treatment strategy. Nowadays the use of surfactants is a part of most treatment protocols. The aim was to study the features of the solid phase bronchoalveolar lavage in children with the ADPs in the dynamics of complex treatment with exogenous surfactant.Material and methods: We examined 39 patients of contaminated surgery. We identified 2 groups of patients. The patients of first group (n=27) had pulmonary pleural form of ADP, the second group (n=12) had pulmonary form of ADP. All patients got classical treatment and the earlier draining of pleural cavity. We used as an antiseptic reamberin 1.5% by 10 ml/kg and endobronchially injected exogenous surfactant Bl in dose12 mg/kg body weight a day, 6 mg/kg every 12 hours. All the children were made a bronchoscopy to obtain BAL to study the crystallization properties. The solid phase of BAL was studied by method of cuneal dehydration.Results: All facies before treatment were divided into two groups according to classification of facies of biological fluids. Only the facies of the second and the third types were detected there. It was revealed that the sizes of the zones of the facies were different in the comparison groups before treatment and after. And the level of crystalline structures and amorphous aggregates were different in the groups with different degrees of inflammation.Conclusion: So, we can assume that the change in surfactant system is characterized by changes in the morphological structure of solids phases of BAL. And the morphological structure of BAL depends on the chemical composition of BAL.
Highlights
Nowadays the use of surfactants is a part of most treatment protocols (Hacimustafaoglu et al, 2004). They have capability to reduce the surface tension at the interface between the alveolar epithelium and the gas of alveoli spaces as well as reduce the risk of nonspecific pulmonary inflammatory responses (Сhotigeat et al, 2008).The exogenous surfactants have a cytoprotective effect on all the structures of the tracheobronchial trunk and the alveolocapillary membrane
There is information that the role of exogenous surfactant as a modulator of the immune response is the stimulation of macrophage migration and phagocytosis and depression of proinflammatory cytokines TNFa and Ilb (Michelow et al, 2004)
Purpose of the work is to study the features of the solid phase of BAL in children with acute destructive pneumonias (ADP) in the dynamics of complex treatment with exogenous surfactant
Summary
Nowadays the use of surfactants is a part of most treatment protocols (Hacimustafaoglu et al, 2004). There is information that the role of exogenous surfactant as a modulator of the immune response is the stimulation of macrophage migration and phagocytosis and depression of proinflammatory cytokines TNFa and Ilb (Michelow et al, 2004). When we use exogenous surfactant for replacement therapy in the treatment of the acute destructive pneumonias (ADP) we will have some difficulties. Many authors use BAL as a material for studying biochemical disorders and functional properties of surfactant (Picinin, Camargos, and Marguet, 2010).
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