Treatment of pleuropneumonia

Inflammation of the chest membrane and lungs is called pleuropneumonia or lobar pneumonia. This is an acute infectious disease, covering one or two lobes of the lungs, exudate appears in their alveoli, and the pleura is enveloped in films of fibrin, an insoluble fibrous protein with which blood coagulates. The causative agents of the disease are type I-IV pneumococci, and its development often takes place against the background of a decrease in immunity and is characterized by a rapid onset, scale and severity of the course. Pleuropneumonia requires immediate treatment within the walls of a hospital. [1]

Means of treatment

Already the first days of the course of the infection are characterized by high fever, shortness of breath, severe cough that appears on the 3rd-4th day of illness, sputum production, pain in the sternum.

Timely treatment can stop the inflammatory process, prevent it from flowing into a life-threatening form. This is facilitated by a comprehensive examination using modern diagnostic methods, placement in a ward equipped with an air conditioning system, selection of antibiotics according to the type of pathogen, the appointment of vasodilators and sputum thinners, corticosteroids, oxygen, and immunoreplacement therapy. [2]

In a serious condition, the patient is placed in intensive care, the wards of which are equipped with heart monitors that allow you to monitor the work of the heart and respiratory organs, and a ventilator.

Medications

The treatment protocol for croupous inflammation involves the simultaneous use of two antibiotics: one intravenously, the other intramuscularly. Usually therapy is carried out with the drugs described below.

Ceftriaxone - belongs to the pharmacological group of III generation cephalosporins, has a wide spectrum of action. The drug is injected once a day. For children from 15 days from birth to 12 years old, the dose is determined at the rate of 20-80 mg per kilogram of body weight, after this age 1-2 g is prescribed.

Ceftriaxone is contraindicated in cases of hypersensitivity to this type of antibiotic, premature infants under 41 weeks of age with intrauterine development, full-term infants up to 28 days of age with jaundice, or those who are to receive calcium supplements. It is not prescribed for pregnant women, especially in the 1st trimester, during lactation. [3]

Side effects were observed in the form of diarrhea, rash, shortness of breath, anemia, headache, increased liver function tests;

Ciprofloxacin - fluoroquinolones, is used at a dose of 400 mg, divided into 2-3 injections per day, for children according to the formula of 10 mg / kg of body weight 3 times. Among the adverse reactions are local around the injection point, rash, stool disorders, flatulence, epigastric pain, anxiety, fever, increased transaminases, dizziness, tremor, rarely convulsions, impaired renal function. [4]

The drug is contraindicated in case of allergy to its components, pregnant women and during lactation. Able to influence the central nervous system, thus the ability to drive a car.

Tsiprolet - is administered intravenously by drip slowly, the duration of the infusion is 60 minutes. Dosage is 200-400 mg twice a day. Not applicable to children under 18 years of age, during pregnancy, lactation.

Adverse reactions are most often manifested in the form of nausea, diarrhea, skin rashes. In less than 1% of cases, other ailments were observed: pain in the abdomen, limbs, back, candidiasis, increased pressure, tachycardia, sweating, sleep disturbance.

Cefazolin is a powder for injection, a semi-synthetic antibiotic. For infections of moderate severity, the recommended dose for adults is 1 g every 12 hours, in more difficult situations, 0.5-1 g every 6-8 hours. For children from 1 month old, it is calculated: per kilogram of weight 20-50 mg, divided into 3-4 injections. If necessary, increase to a maximum of 90-100 mg.

Side effects are possible and are manifested by rashes, itching of the skin, edema, the development of dysbacteriosis, jaundice, an increase in the level of ALT, AST, pallor of the skin, and general weakness. Not recommended for use by pregnant, lactating women.

Cifran is a solution for droppers from the group of fluoroquinols. You can enter 200 mg (30 minutes) at a time or, if necessary, increase to 400 mg (hour) with a multiplicity of 2 times a day. The remedy is contraindicated for children and adolescents, expectant mothers, while breastfeeding. Adverse reactions are the same as previous antibiotics.

Mustard plasters

Treatment of pleuropneumonia is always an integrated approach, with the use of antibacterial, mucolytic, bronchodilator agents. At the same time, there is still a place for mustard plasters in therapy. In the acute phase, they are not used, but when the temperature is reduced to 37 ⁰  and below, then their reflex action can help overcome inflammation.

Mustard oil applied to paper causes hyperemia in places where they adhere to the body, while blood vessels expand, including in the lungs, blood microcirculation increases, inflammatory infiltrate is removed, and immunity is stimulated.

They are applied on and under the shoulder blades, chest, bypassing the area of \u200b\u200bthe heart and spine, preferably at night, after wetting it in warm water. Adults can be placed directly on the body, children are put on gauze soaked in vegetable oil to avoid burns. A plastic film is placed on top of the mustard plasters, then they are insulated with a towel.

The duration of the procedure for small children is 5 minutes, for teenagers - 10 minutes, for adults - 20. Having removed the mustard plasters, they wipe the skin dry and cover themselves with a blanket.

Vitamins

Pleuropneumonia is a very serious disease and the body needs support at this time. Vitamins C, A, E, group B, as well as minerals: iron, calcium, zinc, help resist infection. In addition to including in the diet foods rich in them (lemons, oranges, kiwi, currants, raspberries, cabbage, liver, fish, butter, olive oil, buckwheat), it is recommended to take vitamin and mineral complexes, in which all the useful elements necessary for the body are balanced

Physiotherapy treatment

The use of physiotherapy for pleuropneumonia along with medication reduces the time of therapy and prevents complications. The severe course of the disease forces the use of oxygen therapy - the inhalation of oxygen.

The method of ultraviolet irradiation can be used even during the period of an unfinished febrile state. Its action is directed to the affected area of the lung daily for 2-3 weeks.

7-8 days after acute symptoms, UHF irradiation is prescribed, a course of up to 15 procedures. From the second week, electrophoresis with fibrinolysin-heparin is used.

Thermal procedures (warming compresses, mustard plasters) have a good effect on the pleura. Therapeutic exercises, including breathing, massage prevent the formation of adhesions. Inhalations with the help of a nebulizer are also effective; group electroaerosol inhalations are carried out in a hospital.

Alternative Treatment

Treatment of pleuropneumonia with alternative means can by no means replace the entire complex of therapeutic measures described above, but it can speed up recovery, since it is directed to liquefying sputum and removing it from the body as soon as possible, combating the inflammatory process, and strengthening immunity. For this, summer preparations are used: raspberries, currants, dried fruits, rose hips, as well as lemons, honey. Abundant drinking with their participation (decoctions, infusions, tinctures) is a necessary condition for combating intoxication of the body.

Herbal treatment

In nature, there are many plants and herbs that have anti-inflammatory, wound healing, expectorant properties. Among them are elder flowers, linden, coltsfoot, licorice root, plantain, wild rosemary. Pharmacies sell herbal cough preparations, teas from which will help overcome the disease.

Homeopathy

In homeopathy, in the treatment of pulmonary diseases, they use:

• Aconite napellus (blue fighter) in the fever stage with a strong dry cough;
• Ferrum phosphoricum (iron phosphate) in a state of chest pain, expectoration with blood;
• Bryonia alba (White step) during the period of exudate formation;
• Veratrum viride (Green hellebore) is effective for shortness of breath, weakness, cold sweat.

Diet

Although patients with pneumonia do not have a good appetite, nutrition should be organized in such a way as to help the body cope with the disease.

If in the first most difficult days you need to drink as much liquid as possible (up to 2 liters per day), preferably juices, uzvar, teas containing vitamin C, then in the following days, foods rich in vitamin A are important, because it has a beneficial effect on the epithelium of the respiratory tract. To do this, the diet includes butter, liver, egg yolk, bell pepper.

Sauerkraut, meat broth, pickles will help to stimulate appetite. To restore the intestinal microflora, you will need fermented milk products, cereals, wholemeal bread, boiled fish and meat.

Surgery

The development of purulent complications, a large accumulation of pleural fluid forces it to be pumped out, putting in a drainage system. For 1 time, you can pump out a liter of liquid, otherwise the internal organs may shift.

In order not to further injure the patient, a special port system is installed, connected to a drainage tube in contact with the pleura. This makes it possible not only to remove the liquid, but also to deliver medicinal substances directly to the diseased organ.

Rehabilitation

To restore the functions of the lungs and pleura, it will take a considerable period of time and certain efforts to help return them to their normal state. Rehabilitation includes physiotherapeutic methods, breathing exercises, medication, vitamin complexes, balanced nutrition. The doctor should periodically monitor the condition of his patient.

Prevention

The best preventive measure for pneumonia is pneumococcal vaccination. It is also necessary to lead a healthy lifestyle, harden, spend a lot of time in the fresh air, eat well. Attention should be paid to infections of the upper respiratory tract and take measures to eliminate them.

Clinical examination

Patients who have undergone pleuropneumonia are registered in the dispensary. Clinical examination includes control examinations of patients, recovery procedures. It lasts 6 months, you need to visit a doctor at intervals of 1, 3, 6 months.

During this period, indicators of the general and biochemical blood tests are monitored, sputum analysis, fluorography, measurement of respiratory volumes of the lungs are done. If necessary, consultation of other specialists is appointed.

As wellness activities, a specialized sanatorium, exercise therapy, and vitamin therapy are recommended.

Forecast

Timely treatment with antibiotics, the presence of a pleural puncture method makes the prognosis of pleuropneumonia favorable. But the disease is very insidious, improper treatment, complications with other diagnoses, advanced age, immunodeficiency can lead to death.