Shock lung: the prognosis is favorable
Not an easy shock from a light
Doctors received the award of the Russian government for the treatment of a serious illness
Irina Krasnopolskaya, Rossiyskaya Gazeta – Federal Issue, 03/15/2011
A group of doctors from Moscow, St. Petersburg and Novokuznetsk became laureates of the Russian government award for the development and implementation of methods for the diagnosis and treatment of shock lung.
Shock lung is scientifically called acute respiratory distress syndrome (ARDS). So it is called because in some conditions this organ loses the ability to provide the body with oxygen. There is a life-threatening oxygen starvation.
Almost a pun: all living things live while they breathe. Lungs, respiratory function – the main, indispensable condition of life. Alas, very often it is grossly violated. Reasons? Multiple trauma, blood loss, acute poisoning, sepsis, severe pneumonia, influenza, other severe infectious diseases, bronchitis, complicated childbirth, pancreatic necrosis... This is not a complete list of the big trouble. Obviously, this is an interdisciplinary problem, one of the most difficult in modern science and practice. Doctors of different specialties deal with her. Doctors all over the world are working to ensure that the shock lung ceases to be deadly.
The main difficulty here is timely diagnosis. The fact is that early lung damage is sometimes simply impossible to detect. In any case, this was the case until 2010. In the USA, almost 80-100 thousand people die every year due to shock lung. Unfortunately, there are no statistics on this problem in Russia. Although the problem itself is obvious. During the last flu pandemic, shock lung became the main cause of deaths, especially among overweight people, among pregnant women.
The year 2010 is not named here by chance. By this time, our scientists – for this they were awarded the title of laureates – were able to build a forecast of the possible development of shock lung. It turned out that the main risk factors are genetic predisposition, the nature of the disease, injuries and injuries. Completely different pathologies. That is why it is so important – it rarely happens – that we managed to combine the efforts of various practitioners and scientists working in the field of fundamental medicine into one, if I may say so, scientific and practical team.
The correspondent of "RG" talked with the Moscow representatives of the team in the walls of the Botkin Moscow Clinical Hospital. This largest, oldest hospital in Russia has become one of the main bases for the development and practical application of new approaches in the fight against shock lung.
Vladimir Yakovlev, Chief Physician of Botkin Hospital, Professor: We, like our foreign colleagues, have been dealing with the problem of shock lung for 20 years. And now, in a multidisciplinary hospital, we have managed to put original developments into practice.
Viktor Moroz, Director of the Research Institute of General Resuscitation of the Russian Academy of Medical Sciences, Corresponding Member of the Russian Academy of Medical Sciences: Modern high technologies have made it possible to diagnose a shock lung at the earliest stages of the development of the disease. When it can still be treated effectively, when it is possible to prevent the development of irreversible changes in the body.
Alexander Chuchalin, Director of the Institute of Pulmonology of the FMBA, Academician of the Russian Academy of Medical Sciences: This is fundamentally important: early detection has reduced mortality from 80 to 30 percent or less.
Alexey Vlasenko, Head of the Intensive Care Unit of the Botkin Hospital: For the first time, a method of differentiated diagnosis of different stages of lung disease was substantiated, developed and put into practice. This made it possible to carry out treatment depending on the stage using modern high technologies. The quality of life of patients has significantly improved. And most importantly, Alexander Grigorievich said this, the mortality rate has decreased.
Frost: Representatives of Novokuznetsk are not accidental in the team awarded with a high award. There is a branch of our institute, which specializes in providing intensive care to miners in critical conditions.
Chuchalin: Our study is the first in the world for the diagnosis and treatment of shock lung in miners.
Frost: The state of the miners' organism differs from the state of our organism. Miners work underground, where atmospheric pressure and humidity are significantly increased. And the air they inhale contains the entire periodic table. Naturally, all well-known diseases and injuries occur differently for them. Especially the shock lung.
Vladimir Alekseev, Deputy Chief Physician of the Botkin Hospital, Professor: For the first time, shock lung was mentioned during the First World War under the term "toxic pulmonary edema with phosgene and chlorine poisoning". Subsequently, military doctors had to deal with similar situations with poisoning by rocket fuel components. Firefighters – in case of poisoning by gorenje products. After the publication of our work, inhaled hormonal drugs proposed by us began to be used to prevent the development of toxic pulmonary edema. They are included in the army emergency kits. It is reasonable to use them in the practice of helping with fires.
Rossiyskaya Gazeta: And the famous Botkinskaya reanimobile for obstetric and gynecological care? Is it equipped with equipment that allows you to deal with a shock lung?
Yakovlev: Such a reanimobile has been saving women with various complications of childbirth for many years. And recently, a mobile medical television center appeared in its equipment. This means that both during the movement and on the spot, you can consult the patient with the most experienced specialists.
RG: In recent years, new, highly effective, but very expensive methods of diagnosis and treatment have been emerging. Often they remain not in demand. For various reasons.
Yakovlev: In particular, because there are not enough specialists who know how to manage this wealth. Therefore, it is important not only that we have proposed new methods of diagnosis and treatment, but also that they are being put into practice. Not wide yet. But we are working to make these methods understandable and accessible to all practitioners, so that a shock lung ceases to be a shock, a verdict.
Portal "Eternal youth" http://vechnayamolodost.ru15.03.2011