METABOLIC DISTURBANCES IN SEVERE PNEUMONIA IN CHILDREN: CLINICAL AND PROGNOSTIC SIGNIFICANCE
Keywords:
To assess the comparative clinical and prognostic significance of metabolic disturbances in children with severe pneumonia based on a synthesis of current clinical data.Abstract
Severe pneumonia in children is accompanied by a systemic inflammatory response, hypoxemia, and impaired microcirculation. Under conditions of reduced oxygen delivery, cellular metabolism shifts to the anaerobic pathway, which is accompanied by lactate accumulation, the development of metabolic acidosis, and stress-induced hyperglycemia. International guidelines for the management of sepsis and septic shock in children regard lactate level as one of the markers of disease severity and a benchmark for guiding fluid therapy [1]. The clinical significance of the problem is confirmed by the frequency of adverse outcomes: in a cohort of 617 children with severe pneumonia admitted to the intensive care unit, 28-day mortality was 9.40% [2]. The incidence of severe community-acquired pneumonia increases with age – from 7.37% at 1-3 years to 12.80% at 4-6 years and 18.04% at 7-12 years [3]. At the same time, individual metabolic parameters have mostly been studied in isolation, and their comparative prognostic value has not been systematically summarized.
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