Sagira Abdrakhmanova

Astana Medical University, Kazakhstan

Title: Features of community-acquired pneumonia in children with cerebral palsy

Abstract

The purpose of the study was to establish the characteristics of community-acquired pneumonia (CAP) in children with cerebral palsy and predict based on the study of clinical manifestations.

Methods: The study was conducted in the Multidisciplinary Children's Hospital in Astana (Republic of Kazakhstan). A prospective study followed 351 children. The main group consisted of 56 children with cerebral palsy and community-acquired pneumonia aged 2 to 8 years (girls 41.07% and boys 58.93%). The second group consisted of 100 children with community-acquired pneumonia aged 9 months to 8 years (boys - 62.0%, girls - 38.0%). The comparison group included 66 children with cerebral palsy without CAP aged 2-5 years (boys - 69.7%, girls - 30.3%).

Results: Community-acquired pneumonia in children proceeded with more pronounced respiratory disorders, more pronounced hypoxemia associated with reduced reserve capacity of the respiratory system. Against the background of pneumonia, exacerbation of neurological symptoms was noted. Streptococcus pneumoniae predominated in the etiological structure of bacterial pathogens of CAP in children with cerebral palsy, rhinoviruses and RS- virus dominated in viral ones. A close correlation was established between the severity and severity of CAP clinical manifestations and the level of motor functions according to the GMFCS scale. At the same time, the level of motor function disorders turned out to be more significant than the form of cerebral palsy. In children with cerebral palsy, due to a possible violation of the innervation of the diaphragm, there are a number of functional features that progress with age, which determine the violation of the mechanics of breathing, which can be pathogenetically associated with the development of bronchopulmonary diseases. Based on the results of an ultrasound study, we have developed normative indicators of the functional state of the diaphragm in healthy children aged 0-14 years. We have established statistically significant differences in the morphofunctional state of the diaphragm in children with cerebral palsy, in comparison with healthy children in all respects. A more pronounced increase in the thickness of the diaphragm (on inspiration - by 50%, on expiration - by 60%) with increasing age in children with cerebral palsy than in healthy children (by 20% and 18.2%, respectively). Which is evidence of progressive hypertrophy of the muscular part of the diaphragm in this neurological pathology. At the same time, in children with cerebral palsy, a statistically significant and progressive with age decrease in the contractility of the diaphragm, a decrease in the reserve capacity of the diaphragm to increase the excursion, which also caused an increase in the proportion of patients with cerebral palsy with diaphragm dysfunction, was found. Negative relationships between the thickness of the muscle layer of the diaphragm during inhalation and the thickness of the muscle layer of the diaphragm during exhalation, age on the one hand and the thickening fraction of the muscular layer of the diaphragm on the other hand, indicate that the process of hypertrophy of the muscular part of the diaphragm is associated with a progressive decrease in the contractility of the respiratory muscle with increasing age sick child. Diaphragm dysfunction was diagnosed in 43.9% of patients with cerebral palsy. In healthy children, dysfunction was not observed.

Biography

Sagira Abdrakhmanova graduated from the Almaty Medical Institute in 1979. Specialization - pediatrics, pediatric cardiology. From 1981 to 2007 worked at the Scientific Center of Pediatrics and Pediatric Surgery in Almaty. Since 2007 - Professor of the Department of Children's Diseases No. 2 of the Medical University of Astsns, since 2008 - Head of the Department. Expert of the public chamber "National Chamber of Health", member of the expert group on the modernization of healthcare of the Republic of Kazakhstan Majilis of the Parliament, President of the Astana Association of Pediatricians, member of the Working Groups for the development of clinical guidelines in pediatrics and pediatric cardiology, chief freelance pediatrician of the Ministry of Health of the Republic of Kazakhstan from 2012 to 2014. , Member of the Expert Council of the Educational International Consensus on Respiratory Medicine in Pediatrics, Member of the Board of LLC Union of Pediatricians of the Republic of Kazakhstan. Excellence in Public Health of the Republic of Kazakhstan.

INTERNATIONAL CONFERENCE ON PEDIATRICS AND HEALTHCARE

(HYBRID EVENT) | MAY 22-23, 2023 | DUBAI, UAE

Sagira Abdrakhmanova

Title: Features of community-acquired pneumonia in children with cerebral palsy

Abstract

Biography

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