<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">rmt</journal-id><journal-title-group><journal-title xml:lang="ru">Общая реаниматология</journal-title><trans-title-group xml:lang="en"><trans-title>General Reanimatology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1813-9779</issn><issn pub-type="epub">2411-7110</issn><publisher><publisher-name>FSBI "SRIGR" RAMS</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.15360/1813-9779-2010-1-79</article-id><article-id custom-type="elpub" pub-id-type="custom">rmt-511</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ И КРАТКИЕ СООБЩЕНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS &amp; SHORT COMMUNICATIONS</subject></subj-group></article-categories><title-group><article-title>Вентилятор-ассоциированная пневмония: диагностика, профилактика, лечение (cовременное состояние вопроса)</article-title><trans-title-group xml:lang="en"><trans-title>Ventilator-Associated Pneumonia: Diagnosis, Prevention, Treatment (State-of-the-Art of the Problem)</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Егорова</surname><given-names>И. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Yegorova</surname><given-names>I. N.</given-names></name></name-alternatives></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Власенко</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Vlasenko</surname><given-names>A. V.</given-names></name></name-alternatives><email xlink:type="simple">dr.vlasenko@mail.ru</email></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мороз</surname><given-names>В. В</given-names></name><name name-style="western" xml:lang="en"><surname>Moroz</surname><given-names>V. V.</given-names></name></name-alternatives></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Яковлев</surname><given-names>В. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Yakovlev</surname><given-names>V. N.</given-names></name></name-alternatives></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Алексеев</surname><given-names>В. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Alekseyev</surname><given-names>V. G.</given-names></name></name-alternatives></contrib></contrib-group><pub-date pub-type="collection"><year>2010</year></pub-date><pub-date pub-type="epub"><day>20</day><month>02</month><year>2010</year></pub-date><volume>6</volume><issue>1</issue><issue-title>Том VI № 1 2010 г.</issue-title><fpage>79</fpage><lpage>79</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Егорова И.Н., Власенко А.В., Мороз В.В., Яковлев В.Н., Алексеев В.Г., 2010</copyright-statement><copyright-year>2010</copyright-year><copyright-holder xml:lang="ru">Егорова И.Н., Власенко А.В., Мороз В.В., Яковлев В.Н., Алексеев В.Г.</copyright-holder><copyright-holder xml:lang="en">Yegorova I.N., Vlasenko A.V., Moroz V.V., Yakovlev V.N., Alekseyev V.G.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.reanimatology.com/rmt/article/view/511">https://www.reanimatology.com/rmt/article/view/511</self-uri><abstract><p>Представлен обзор современного состояния проблемы вентилятор-ассоциированной пневмонии в отделениях реанимации на основании анализа данных современной отечественной и зарубежной литературы, собственного многолетнего опыта работы. Подробно изложены вопросы этиологии, эпидемиологии, патогенеза вентилятор-ассоциированной пневмонии, возможности и ограничения способов ее профилактики и методов диагностики, успехи и трудности лечения этой патологии.</p></abstract><trans-abstract xml:lang="en"><p>By analyzing the data available in the Russian and foreign literature and their many years’ experience, the authors review the state-of-the-art of the problem associated with ventilator-associated pneumonia in intensive care units. The etiology, epidemiology, and pathogenesis of ventilator-associated pneumonia, the possibilities and limitations of its prevention and diagnostic methods, successes and difficulties and treatment of this pathology are described in detail.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>нозокомиальная пневмония</kwd><kwd>вентилятор-ассоциированная пневмония</kwd><kwd>искусственная вентиляция легких</kwd><kwd>отделение реанимации.</kwd></kwd-group><kwd-group xml:lang="en"><kwd>nosocomial pneumonia</kwd><kwd>ventilator-associated pneumonia</kwd><kwd>artificial ventilation</kwd><kwd>intensive care unit.</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Rello J., Ollendorf D. A., Oster G. et al.</mixed-citation><mixed-citation xml:lang="en">Rello J., Ollendorf D. A., Oster G. et al.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Niederman M. S., Craven D. E., Fein A. M. et al.Pneumonia in the critically ill hospitalised patient. Chest 1990; 97 (1): 170—181.</mixed-citation><mixed-citation xml:lang="en">Niederman M. S., Craven D. E., Fein A. M. et al.Pneumonia in the critically ill hospitalised patient. Chest 1990; 97 (1): 170—181.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Pingleton S. K., Fagon J. Y., Leeper K. V.Patient selection for clinical investigation of ventilator-associated pneumonia. Criteria for evaluating diagnostic techniques. Chest. 1992; 102 (5 Suppl 1): 553S—556S.</mixed-citation><mixed-citation xml:lang="en">Pingleton S. K., Fagon J. Y., Leeper K. V.Patient selection for clinical investigation of ventilator-associated pneumonia. Criteria for evaluating diagnostic techniques. Chest. 1992; 102 (5 Suppl 1): 553S—556S.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Light R.B.Ventilator associated pneumonia: asking the right question. Thorax 1999; 54 (10): 863—86</mixed-citation><mixed-citation xml:lang="en">Light R.B.Ventilator associated pneumonia: asking the right question. Thorax 1999; 54 (10): 863—86</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Rello J, Ausina V., Ricart M. et al.Impact of previous antimicrobial therapy on the etiology and outcome of ventilator-associated pneumonia. Chest 1993; 104 (4): 1230—123</mixed-citation><mixed-citation xml:lang="en">Rello J, Ausina V., Ricart M. et al.Impact of previous antimicrobial therapy on the etiology and outcome of ventilator-associated pneumonia. Chest 1993; 104 (4): 1230—123</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Rello J., Quintana E., Ausina V. et al.Incidence, etiology, and outcome of nosocomial pneumonia in mechanically ventilated patients, Chest 1991; 100 (2): 439—444.</mixed-citation><mixed-citation xml:lang="en">Rello J., Quintana E., Ausina V. et al.Incidence, etiology, and outcome of nosocomial pneumonia in mechanically ventilated patients, Chest 1991; 100 (2): 439—444.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Heyland D. K., Cook D. J., Griffith L. et al.The atributable morbitidy and mortality of ventilator associated pneumonia in the critically ill patient. The Canadian Critical Trials Group. Am. J. Respir. Crit. Care Med. 1999, 159 (4 Pt 1): 1249—1256.</mixed-citation><mixed-citation xml:lang="en">Heyland D. K., Cook D. J., Griffith L. et al.The atributable morbitidy and mortality of ventilator associated pneumonia in the critically ill patient. The Canadian Critical Trials Group. Am. J. Respir. Crit. Care Med. 1999, 159 (4 Pt 1): 1249—1256.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">National Nosocomial Infections Surveillance (NNIS) System report, data summary from January 1990 — May 1999, issue June 1999. An. J. Infect. Control 1999; 27: 520—532.</mixed-citation><mixed-citation xml:lang="en">National Nosocomial Infections Surveillance (NNIS) System report, data summary from January 1990 — May 1999, issue June 1999. An. J. Infect. Control 1999; 27: 520—532.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Fagon J. Y., Chastre J., Hance A. J. et al.Nosocomial pneumonia in ventilated patients: a cohort study evaluating attributable mortality and hospital stay. Amer. J. Med. 1993; 94 (3): 281—288.</mixed-citation><mixed-citation xml:lang="en">Fagon J. Y., Chastre J., Hance A. J. et al.Nosocomial pneumonia in ventilated patients: a cohort study evaluating attributable mortality and hospital stay. Amer. J. Med. 1993; 94 (3): 281—288.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Яковлев С. В.Госпитальные пневмонии вопросы диагностики и антибактериальной терапии Consilium medicum 2000, 2, 400—404.</mixed-citation><mixed-citation xml:lang="en">Яковлев С. В.Госпитальные пневмонии вопросы диагностики и антибактериальной терапии Consilium medicum 2000, 2, 400—404.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am. J. Respir. Crit. Care Med. 2005, 171 (4): 388—416.</mixed-citation><mixed-citation xml:lang="en">Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am. J. Respir. Crit. Care Med. 2005, 171 (4): 388—416.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Bagshaw S. M., Laupland K. B.Epidemiology of intensive care unit-acquired urinary tract infections. Curr. Opin. Infect. Dis. 2006; 19 (1): 67—71.</mixed-citation><mixed-citation xml:lang="en">Bagshaw S. M., Laupland K. B.Epidemiology of intensive care unit-acquired urinary tract infections. Curr. Opin. Infect. Dis. 2006; 19 (1): 67—71.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Гельфанд Б. Р., Гологорский В. А., Белоцерковский Б. З. и соавт.Нозо-комиальная пневмония, связанная с ИВЛ у хирургических больных. М.; 2000.</mixed-citation><mixed-citation xml:lang="en">Гельфанд Б. Р., Гологорский В. А., Белоцерковский Б. З. и соавт.Нозо-комиальная пневмония, связанная с ИВЛ у хирургических больных. М.; 2000.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Белобородова Н. В.Бактериемия и сепсис. Пособие для врачей «Инфекция в стационаре». М.; 2008.</mixed-citation><mixed-citation xml:lang="en">Белобородова Н. В.Бактериемия и сепсис. Пособие для врачей «Инфекция в стационаре». М.; 2008.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Grigoriu B., Jacobs F., Beuzen F. et al.Bronchoalveolar lavage cytologi-cal alveolar damage in patients with severe pneumonia. Crit. Care 2006; 10 (1): R2.</mixed-citation><mixed-citation xml:lang="en">Grigoriu B., Jacobs F., Beuzen F. et al.Bronchoalveolar lavage cytologi-cal alveolar damage in patients with severe pneumonia. Crit. Care 2006; 10 (1): R2.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Chastre J., Fagon J. Y., Soler P. et al.Diagnosis of nosocomial bacterial pneumonia in intubated undergoing ventilation: comparison of the usefulness of bronchoalveolar lavage and protected specimen brush. Amer. J. Med. 1988; 85 (4): 499—506.</mixed-citation><mixed-citation xml:lang="en">Chastre J., Fagon J. Y., Soler P. et al.Diagnosis of nosocomial bacterial pneumonia in intubated undergoing ventilation: comparison of the usefulness of bronchoalveolar lavage and protected specimen brush. Amer. J. Med. 1988; 85 (4): 499—506.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Russwurms S., Wiederhold W., Oberhoffer M. et al.Procalcitonin as a monocyte marker for early diagnosis in septic abortus (in German). Z. Geburtsh Neonatal. 1999; 14: 29—33.</mixed-citation><mixed-citation xml:lang="en">Russwurms S., Wiederhold W., Oberhoffer M. et al.Procalcitonin as a monocyte marker for early diagnosis in septic abortus (in German). Z. Geburtsh Neonatal. 1999; 14: 29—33.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Nijsten M. W., Olinga P., de Vries E. G. et al.Procalcitonin behaves as a fast responding acute phase proteinin vivoandin vitro.Crit. Сare Med. 2000; 28 (2): 458-461.</mixed-citation><mixed-citation xml:lang="en">Nijsten M. W., Olinga P., de Vries E. G. et al.Procalcitonin behaves as a fast responding acute phase proteinin vivoandin vitro.Crit. Сare Med. 2000; 28 (2): 458-461.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Christ-Crain M., Jaccard-Stolz D., Bingisser R. et al.Effect of procalci-tonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single-blinded intervention trial. Lancet 2004; 363 (9409): 600—607</mixed-citation><mixed-citation xml:lang="en">Christ-Crain M., Jaccard-Stolz D., Bingisser R. et al.Effect of procalci-tonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single-blinded intervention trial. Lancet 2004; 363 (9409): 600—607</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Lowy F. D., Carlisle P. S., Adams A., Feiner C.The incidence of nosoco-mial pneumonia following urgent endotracheal intubation. Infect. Control 1987; 8 (6): 245—248.</mixed-citation><mixed-citation xml:lang="en">Lowy F. D., Carlisle P. S., Adams A., Feiner C.The incidence of nosoco-mial pneumonia following urgent endotracheal intubation. Infect. Control 1987; 8 (6): 245—248.</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Martone W. J., Jarvis W. R., Culver U. H., Haley R. W.Incidence and nature of endemic and epidemic nosocomial infections. In: Bennett JV, Brachman PS, eds. Hospital infections, 3rd ed. Boston: Little, Brown and Co.; 1993. 577—596.</mixed-citation><mixed-citation xml:lang="en">Martone W. J., Jarvis W. R., Culver U. H., Haley R. W.Incidence and nature of endemic and epidemic nosocomial infections. In: Bennett JV, Brachman PS, eds. Hospital infections, 3rd ed. Boston: Little, Brown and Co.; 1993. 577—596.</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Fagon J. Y.- Chastre J.- Hance A. J. et al.Nosocomial pneumonia in ventilated patients: a cohort study evaluating attributable mortality and hospital stay. Amer. J. Med. 1993; 94 (3): 281—288.</mixed-citation><mixed-citation xml:lang="en">Fagon J. Y.- Chastre J.- Hance A. J. et al.Nosocomial pneumonia in ventilated patients: a cohort study evaluating attributable mortality and hospital stay. Amer. J. Med. 1993; 94 (3): 281—288.</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">Leu H. S.- Kaiser D. L.- Mori M. et al.Hospital-acquired pneumonia: attributable mortality and morbidity. Amer J Epidemiol 1989; 129 (6): 1258—1267.</mixed-citation><mixed-citation xml:lang="en">Leu H. S.- Kaiser D. L.- Mori M. et al.Hospital-acquired pneumonia: attributable mortality and morbidity. Amer J Epidemiol 1989; 129 (6): 1258—1267.</mixed-citation></citation-alternatives></ref><ref id="cit24"><label>24</label><citation-alternatives><mixed-citation xml:lang="ru">Kollef M. H.- Ward S.The influence of mini-BAL cultures on patient outcomes: implications for the antibiotic management of ventilator-associated pneumonia. Chest 1998; 113 (2): 412—420.</mixed-citation><mixed-citation xml:lang="en">Kollef M. H.- Ward S.The influence of mini-BAL cultures on patient outcomes: implications for the antibiotic management of ventilator-associated pneumonia. Chest 1998; 113 (2): 412—420.</mixed-citation></citation-alternatives></ref><ref id="cit25"><label>25</label><citation-alternatives><mixed-citation xml:lang="ru">Edmondson E. B.- Reinarz J. A.- Pierce A. K.- Sanford J. P.Nebulization equipment: a potential source of infection in gram-negative pneumonia&amp;#8217;s. Amer. J. Dis. Child 1966; 111 (4): 357—360.</mixed-citation><mixed-citation xml:lang="en">Edmondson E. B.- Reinarz J. A.- Pierce A. K.- Sanford J. P.Nebulization equipment: a potential source of infection in gram-negative pneumonia&amp;#8217;s. Amer. J. Dis. Child 1966; 111 (4): 357—360.</mixed-citation></citation-alternatives></ref><ref id="cit26"><label>26</label><citation-alternatives><mixed-citation xml:lang="ru">Kollef M. H.Ventilator-associated pneumonia: the importance of initial empirical antibiotic selection. Infect. Med. 2000; 17 (4): 265—268, 278—283.</mixed-citation><mixed-citation xml:lang="en">Kollef M. H.Ventilator-associated pneumonia: the importance of initial empirical antibiotic selection. Infect. Med. 2000; 17 (4): 265—268, 278—283.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
