Features of respiratory tactic for bilateral interstitial pneumonia in the setting of the chronic rejection of kidney graft

A case of interstitial pneumonia in a patient with the chronic rejection of kidney transplant is presented. Criteria for diagnosis were: medical history (chronic rejection of transplant in 3 months after transplantation; positive results of CMV, Mycoplasma, Toxsoplasma samples); critical parameters of the respiratory status on admission (expressed excitement, auxiliary muscles participating in breathing with rate higher than 30 per min, increasing cyanosis with SO2% and PaO2 higher than 70 mmHg); X-ray have shown bilateral subtotal infiltrative damage of both lungs. By analyzing clinical situation with the development of acute respiratory distress syndrome on the background of expressed damage of the immune status of patient and the progression of multi-organ failure, we used an available arsenal of replacement therapy and intensive care with positive results. Opportunities and benefits of using intrapulmonary percussion ventilation and non-invasive ventilation in respiratory therapy complex were found. Medication with FarGALS that has strong antiseptic activity and wide spectrum of antimicrobial effect (against Gram-positive and Gram-negative, aerobes and anaerobes, non spore-forming and spore-forming bacteria, fungi of the genus Candida) was used with therapeutic tracheo-bronchial lavage. The use of integrated approach with the use of hemodialysis, non-invasive respiratory methods with original antibacterial therapeutic lavage of the respiratory tract may be the alternative treatment tactic in this group of patients.

трансплантация почки, легочная инфекция, неинвазивная искусственная вентиляция легких, интрапульмональная перкуссионная вентиляция, renal transplantation, respiratory infection, non-invasive constant positive airway pressure, intrapulmonic percussion ventilation

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