PNEUMONIA IN NEWBORN BABIES ON VENTILATORS

Abstract

Depending on the time and conditions of infection, neonatal pneumonia is divided into intrauterine and postnatal pneumonia, which can be out ofhospital, nosocomial, ventilator-associated, aspiration. Congenital pneumonia, difficult to distinguish from respiratory distress syndrome of newborns, a component of generalized infection of the fetus and newborn. According to the time of clinical manifestations, neonatal pneumonia is divided into early (1st week of life) and late (8-28th day of life). The etiology of pneumonia in newborns depends on the time, path and conditions of infection. Diagnosis of the disease in newborns is determined by the level and equipment of the clinic and is based on the detection of antenatal and postnatal risk factors, respiratory and general symptoms, radiographic signs, markers of systemic syndrome inflammatory reaction / bacterial infection and the results of etiological diagnosis. The deterioration of the newborn on a ventilator may be due not only toventilator-associatedpneumonia, but also to other fan-associated events (ventilator-associated condition; ventilatorassociatedevent in children receiving antimicrobials), the causes of which may be pulmonary edema, atelectasis, acute respiratory distress syndrome, recent surgical procedures, sepsis, formation of bronchopulmonary dysplasia. For the initial therapy of early pneumonia of newborns, a combination of ampicillin with gentamicin is used. With late neonatal pneumonia that has arisen in the hospital, primary therapy must necessarily include antipseudomonas and antistaphylococcal antibiotics. For the treatment of community-acquired pneumonia in newborn children, antibiotics are prescribed that act on gramnegative bacteria (inhibitors of protected P-lactams, cephalosporins of the III generation, aminoglycosides).