ABSTRACT
Aim To study the effectiveness of nebulized surfactant therapy as a part of a multimodality treatment of severe and extremely severe COVID-19 viral pneumonia with concomitant cardiovascular diseases (CVDs).Material and methods This retrospective controlled study analyzed a multimodality treatment of 38 patients with severe and extremely severe COVID-19 viral pneumonia and concomitant CVDs who were administered nebulized surfactant for correction of acute respiratory distress syndrome (ARDS). The control group consisted of 105 patients with severe and extremely severe novel coronavirus infection with concomitant CVDs who were not administered surfactant as a part of the multimodality therapy.Results Administration of nebulized surfactant as a part of the multimodality treatment in patients with COVID-19 allowed alleviating the severity of respiratory insufficiency (Ñ<0.001), which decreased the death rate of patients with severe and extremely severe COVID-19 and undoubtedly demonstrated the effectiveness of this medicine. The timely multimodality therapy, including nebulized surfactant, improves the course of the disease. Thus, the absence of a possibility for administering nebulized surfactant for more than 4 days was associated with fatal outcomes (Ñ=0.045).Conclusion Administration of nebulized surfactant as a part of the multimodality treatment of severe and extremely severe COVID-19 and concomitant CVDs increases the survival (Ñ<0.001) and reduces the mortality by 46â%. The risk factors of an unfavorable outcome of this disease include an age older than 65 (Ñ=0.020), a positive polymerase chain reaction test (Ñ=0.037), a ferritin concentration at baseline >600 mgâ/ml (Ñ<0.001), and a surfactant treatment duration < 4 days (Ñ=0.045). Further study of the efficacy of nebulized surfactants as a part of the multimodality therapy is required and should include randomized clinical trials with a large number of patients and the development of distinct criteria for the treatment of ARDS.
Subject(s)
COVID-19 , Respiratory Distress Syndrome , COVID-19/complications , Humans , Respiratory Distress Syndrome/complications , Respiratory Distress Syndrome/drug therapy , Retrospective Studies , SARS-CoV-2 , Surface-Active AgentsABSTRACT
The results of the study of the level of pancreatic hormones (insulin, glucagon, C-peptide and trypsin), carried out with the aim of finding out the character of relationship between hormonal disturbances and the state of carbohydrate metabolism, as well as the influence of oral rehydration therapy (ORT) with glucose-salt solutions on the function of the pancreas, are summarized. All subjects to be examined were divided into two groups receiving different kinds of ORT. The patients in group 1 (153 subjects) were treated with glucosolan and in group 2 (73 subjects), with sodium citrate in an amount of 2.5-5 lit. over the 6-hour period of treatment. The determination of the content of immunoreactive insulin, glucagon C-peptide and trypsin in the blood as the characteristics of the hormonal activity of the pancreas has made it possible to find out disturbances in the incretory and excretory activity of the pancreas in patients with acute enteric infections of different etiology. ORT with glucosolan and sodium citrate facilitates the restoration of pancreatic function in 65-70% of in patients with acute enteric infections of different etiology.
Subject(s)
Dysentery, Bacillary/therapy , Fluid Therapy , Intestinal Diseases/therapy , Pancreas/physiopathology , Salmonella Food Poisoning/therapy , Vibrio Infections/therapy , Acute Disease , Adolescent , Adult , Blood Glucose/analysis , Dysentery, Bacillary/blood , Dysentery, Bacillary/physiopathology , Female , Fluid Therapy/methods , Humans , Intestinal Diseases/blood , Intestinal Diseases/physiopathology , Male , Pancreatic Hormones/blood , Salmonella Food Poisoning/blood , Salmonella Food Poisoning/physiopathology , Vibrio Infections/blood , Vibrio Infections/physiopathologyABSTRACT
ORT effectiveness for AII cases of different etiology was studied in two groups of patients: 153 patients as ORT received glucosalan (group 1), 75 patients underwent ORT with sodium citrate in solution from 2.5 to 51 within 6 hours. Both group 1 and group 2 patients benefited from the above solutions as following 6 hours of treatment their biochemical and clinical indices improved. The patients attained normal coagulation, filter-reabsorption renal function under disappearance of dehydration and intoxication symptoms. Availability and simplicity of ORT procedure enable its usage prior to hospitalization, in outpatient departments, at home, making hospitalization unnecessary if started at the initial AII stages.
