Pediatric Hematology/Oncology and ImmunopathologyPediatric Hematology/Oncology and ImmunopathologyВопросы гематологии/онкологии и иммунопатологии в педиатрии1726-17082414-9314Fund Doctors, Innovations, Science for Children31510.24287/1726-1708-2020-19-1-122-130LITERATURE REVIEWОБЗОР ЛИТЕРАТУРЫRespiratory failure in children with oncohematological and immunological diseases: methods of treatmentДыхательная недостаточность у детей с онкогематологическими и иммунологическими заболеваниями и методы ее коррекцииhttps://orcid.org/0000-0002-4348-4573IvanashkinA. Y.ИванашкинА. Ю.
Russian Federation

MD, Intensive Care Unit, 

117997, Moscow, Samory Mashela st., 1

врач анестезиолог-реаниматолог, 

117997, Москва, ГСП-7, ул. Саморы Машела, 1

ivanashkin@mail.ruhttps://orcid.org/0000-0001-8417-3555LazarevV. V.ЛазаревВ. В.
Russian Federation

Moscow

Москва

Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology Ministry of Healthcare of Russian FederationФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева» Минздрава РоссииN.I. Pirogov Russian National Research Medical UniversityФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России280320201911221302803202028032020Copyright ©; 2020, «D. Rogachev NMRCPHOI»Copyright ©; 2020, ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава России2020«D. Rogachev NMRCPHOI»ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава Россииhttps://creativecommons.org/licenses/by/4.0https://hemoncim.com/jour/article/view/315

Acute respiratory distress syndrome (ARDS) against the background of a lung infection is one of the chief reasons for a fatal outcome in children with oncohematological and immunological diseases. This is due to the fact that in 16–24% of these patients, it is not possible to treat critical hypoxemia successfully using the traditional methods of mechanical ventilation (MV) of the lungs. For patients with ARDS, the method of choice for treating critical hypoxemia is extracorporeal membrane oxygenation (ECMO), but pronounced cytopenia, immunosuppression and hemostatic system disorders constitute absolute contraindications for ECMO, owing to a high risk of numerous fatal complications. Therefore, there remains currently a rather relevant problem: specifically, the search for alternative methods of mechanical ventilation, which would aim to improve oxygenation and gas exchange during severe forms of ARDS in children with oncohematological and immunological diseases. One of such methods is superimposed high-frequency jet ventilation (SHFJV).

Острый респираторный дистресс-синдром (ОРДС) на фоне инфекционного поражения легких – одна из основных причин летального исхода у детей с онкогематологическими и иммунологическими заболеваниями. Это связано с тем, что у 16–24% таких пациентов не удается скорректировать критическую гипоксемию традиционными методами искусственной вентиляции легких (ИВЛ). У пациентов с ОРДС методом выбора при лечении критической гипоксемии служит экстракорпоральная мембранная оксигенация (ЭКМО), однако выраженная цитопения, иммуносупрессия и нарушения в системе гемостаза являются абсолютными противопоказаниями к ЭКМО в связи с высоким риском развития большого количества фатальных осложнений. Таким образом, остается актуальной проблема поиска альтернативных методов ИВЛ, направленных на улучшение оксигенации и газообмена при тяжелых формах ОРДС у детей с онкогематологическими и иммунологическими заболеваниями. Один из таких методов – сочетанная высокочастотная струйная вентиляция легких.

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