CHARACTERISTICS OF PATIENTS WITH DISSEMINATED LUNG DISEASES IN THE INTENSIVE THERAPY UNIT

Background. Diagnosis of diseases with the syndrome of dissemination of the lung tissue presents considerable difficulties. Aim. To study peculiarities of patients with disseminated diseases of lungs admitted for treatment to the resuscitation and intensive care unit (ICU) of Municipal hospital rendering emergency pulmonological care 24 hours a day. Materials and methods. Standard clinical X-ray, laboratory and instrumental examinations of patients with disseminated lung diseases who underwent treatment in the resuscitation and intensive care unit (ICU) in 2015 were conducted. Criteria for hospitalization were: SatO2<90%, the presence of signs of bilateral lesion of the lung tissue in X-ray picture with rapid development of clinical symptoms. The structure of disseminated diseases of lungs, peculiarities of the clinical course and outcomes were studied. Results. Patients with disseminated diseases of lungs made 10.9% of the total annual amount of ICU patients. On admission to hospital 89.4% of patients had the diagnosis of indeterminate pneumonia (J18.9) and 10.6% – other interstitial pulmonary diseases (J84). The age of almost half the patients was from 30 to 39 years; 69.1% were non-working individuals of the working age, 12.8% – homeless individuals, 37.2 % – drug users, 71.8% – HIV-infected, and 10.3% – alcoholics. After standard laboratory and instrumental examinations the following diagnoses were made: 58.9% – community-acquired pneumonias, 24.4% – disseminated tuberculosis, 10.3% – alveolites, 3.8% canceromatosis and 2.6% – sarcoidosis. Mycobacteria of tuberculosis were identified in 52.6%, the average time for making diagnosis of tuberculosis was 5±2.6 days. 93.4% Of patients in the group with the diagnosis of community-acquired pneumonia were HIV associated, and 68.4% were with lung tuberculosis. Lethal outcome was in 46.5% of cases of pneumonia and in 47.4% of cases of tuberculosis. Conclusion. Lung diseases with dissemination syndrome requiring intensive treatment are socially determined, highly associated with HIV infection, with more that 40% lethality and identification of disseminated tuberculosis in 24% of cases.