Treatment regimen and nutrition in case of pneumonia

Treatment regimen

Treatment of a patient with acute pneumonia is usually performed in a hospital. Obligatory hospitalization is subject to patients with croupous pneumonia, with complicated forms of acute pneumonia, with severe clinical course with severe intoxication, with severe concomitant diseases, as well as inability to obtain quality outpatient treatment (lack of constant medical supervision, residence in a hostel, etc.) . Outpatiently, only mildly leaking pneumonia can be treated with proper care of the patient.

The American Thoracic Association cites the following indications for hospitalization of patients with community-acquired pneumonia, based on the risk of high mortality and complications:

• age over 65;
• presence of concomitant diseases - chronic bronchial obstruction, bronchiectasis, pneumofibrosis, diabetes mellitus, chronic renal failure, congestive heart failure, chronic liver diseases of various etiologies, suspicion of aspiration of gastric contents, mental disorders;
• chronic alcoholism;
• condition after splenectomy;
• severe pneumonia (respiratory rate at 1 minute more than 30, severe respiratory failure, need for mechanical ventilation, x-ray data on bilateral lesions of several parts, BP systolic below 90 mmHg, BP diastolic below 60 mmHg, temperature bodies above 38.3 C, urine volume less than 20 ml / h, indicating renal failure or transient oliguria, as in patients with shock);
• signs of septicemia;
• laboratory data - the number of leukocytes <4х10 ⁹ / l or> 30х10 ⁹ / l or the absolute number of neutrophils below 1х10 ⁹ / l: PaO2 <60 mm. Gt; Art. Or Ra CO2> 50 mm. Gt; p. Creatinine in the blood> 1.2 mg / dL; hematocrit <30%, hemoglobin <90 g / l; presence of metabolic acidosis; increased mrothrombin and thromboplastin time.

Bed rest is observed during the entire febrile period and intoxication, and also before the elimination of complications. Three days after the normalization of body temperature and the disappearance of intoxication, a semi-postal and then ward regime is appointed.

Approximate periods of temporary incapacity for work in acute pneumonia depend on the degree of its severity, the presence of complications and are:

• with a mild form of acute pneumonia 20-21 days;
• with an average form of 28-29 days;
• with severe form, as well as with complications (abscess, exudative pleurisy, empyema of the pleura) - 65-70 days.

Of great importance in the treatment of acute pneumonia is the proper care for the patient: a spacious room; good lighting; ventilation; fresh air in the room, which improves sleep, stimulates the mucociliary function of the bronchial tree; careful care of the oral cavity. It is advisable to install apparatuses for air ionization in the chamber with negative ions. Inhalation of such air contributes to a significant improvement in the drainage function of the bronchi, reduces bronchospastic phenomena, accelerates the resorption of the inflammatory focus.

Health food

In an acute febrile period of the disease, in the absence of symptoms of heart failure, the patient should be recommended to use about 2.5-3 liters of liquid: slightly acidified mineral water or boiled water with lemon juice, cranberry juice, fruit juices, vitamin infusions (rose hips, etc.). In the early days, the diet consists of a variety of easily digestible products, compotes, fruits.

In the future, a diet is prescribed that provides a sufficient number of proteins, fats, carbohydrates, vitamins, i.e. Tables number 10 or number 15. Chicken broths are useful. Smoking and alcohol are prohibited.