Pneumonia in bedridden patients in most cases is a consequence of stagnation of blood in the pulmonary circulation.. Symptoms of early hypostatic pneumonia are often masked by signs of the underlying pathology (heart attack, stroke, heart failure), so it is very difficult to recognize the disease, according to Pannochka, an online publication for girls and women aged 14 to 35.. net Pneumonia in bedridden patients is difficult to diagnose. Treatment of pathology is difficult, since most often the patient has many pathological changes in internal organs.. Due to low mobility, there is a violation of the blood supply and, as a result, swelling and bedsores.

Congestive pneumonia in bedridden patients may be:.

early: occurs in the first days of bed rest;

late: symptoms of the disease appear 4–6 weeks after the patient has become bedridden.

Since the diagnosis of pneumonia is difficult, and antibiotics often do not give the desired effect, the prognosis is unfavorable.. A rapid transition from the initial stage to the terminal stage can be fatal.

Causes The movements of the chest during inhalation and exhalation play a large role in the act of breathing.. If the patient is in a supine position for a long time, the amplitude of the chest during breathing is limited.

Breathing is reflex and is regulated by the respiratory center, which is located in the brain. Due to the lowering of the diaphragm and contraction of the external intercostal muscles, the chest expands, and negative pressure is created in the chest cavity..

The main function of the lungs is to provide gas exchange between alveolar air and blood. This allows the alveoli to fill with air and creates blood flow to the pulmonary arteries.. Gas exchange occurs in the alveoli, oxygen enters the blood, and carbon dioxide is removed from the blood into the lumen..

Normally, after gas exchange, a full exhalation occurs.. At this point, the diaphragm relaxes and the internal intercostal muscles contract.. As a result, there is a reduction in the volume of the chest cavity and the expulsion of air and oxygenated blood from the pulmonary circulation.. Together with the air, dust and mucus come out.

In a lying person, this process is disrupted, due to inadequate respiratory movements, blood stagnates in the pulmonary vessels, and mucus and dust accumulate in the lungs.. This becomes a prerequisite for the development of the inflammatory process..

When breathing, chest movements play an important role. Also, due to the weakening of local immunity, pathogenic microorganisms that enter the body can begin to actively multiply, as a result of which the patient may experience viral, bacterial or fungal pneumonia.

Trigger factors Factors affecting the development of the disease:.

elderly patient (over 60 years old);

cardiovascular diseases;

chronic diseases of the bronchopulmonary system;

immune disorders;

staying in one position for a long period;

violation of personal hygiene rules.

Symptoms The following symptoms indicate the development of congestive pneumonia in bedridden patients:.

prolonged unproductive cough, in which sputum does not come out well;

shortness of breath when lying down;

crackling sound that occurs when breathing (pleural crepitus);

pain in the chest with inflammation of the lung parenchyma;

increase in body temperature up to 37.0–37.5 °С;

lack of appetite;

weakness and apathy.

One of the symptoms of pneumonia is an increase in body temperature. The patient has dry rales that can be heard when listening with a phonendoscope.. A digital examination of the chest wall reveals a shortened percussion sound..

Signs of manifesting bilateral pneumonia If treatment is not started in a timely manner, pneumonia turns into a manifesting bilateral form, while the patient has symptoms such as:.

severe shortness of breath;

moist rales;

increase in body temperature up to 39.0–40.0 °С;

persistent cough with an abundance of mucopurulent sputum.

In some cases, the patient has hemoptysis, which is a very unfavorable sign.. In addition, the patient has severe symptoms of intoxication, including chills, sweating, nausea, vomiting, confusion..

Extrapulmonary symptoms of pneumonia In addition to the main signs of the disease, almost 75% of elderly bedridden patients have extrapulmonary symptoms of the disease:.

body system.

Symptoms.

Digestive system.

Nausea, vomiting, abdominal pain, lack of appetite.

The cardiovascular system.

Arrhythmia, tachycardia, congestion in the lower extremities.

Nervous system.

Headache, dizziness, confusion, lethargy, drowsiness.

urinary system.

Back pain, difficulty or uncontrolled urination.

The appearance of extrapulmonary symptoms of the disease aggravates the patient's condition and makes the prognosis even more unfavorable..

Asymptomatic course of pathology In bedridden patients, pneumonia is very often almost asymptomatic.. The patient may experience only mild shortness of breath, which is attributed to the weakening of the body. Inflammation of the lungs in the elderly quickly passes from the initial stage to bilateral infiltration of the alveolar tissue..

It is quite difficult to determine the disease at the initial stage, since shortness of breath can be a sign of heart disease, allergic bronchial constriction, or chronic broncho-obstructive pathology..

This is complicated by the fact that the doctor cannot correctly interpret the data that he receives when tapping and listening with a phonendoscope. Additionally, in bedridden elderly patients, as a result of tissue scarring, pneumosclerosis of the pulmonary parenchyma develops..

DiagnosisThe disease can be diagnosed by a doctor who treats the underlying pathology (pulmonologist, cardiologist, neurologist, internist, traumatologist). He collects an anamnesis and prescribes the following studies:.

complete blood count (with infectious pneumonia, the ESR and the number of leukocytes increase);

X-rays of light;

blood chemistry;

bacterial culture of sputum;

Analysis of urine;

bronchoscopy;

lung tomography.

Pneumonia can be diagnosed by a doctor who treats the underlying pathology of a bedridden patient. Treatment The goal of therapy The goal of treating congestive pneumonia is:.

elimination of the infection that caused the disease;

removal of exudate from the lungs;

elimination of congestion in the lungs;

restoration of the drainage function of the bronchi;

immune stimulation.

Antibiotic therapy Treatment of pathology in bedridden patients is carried out with the help of antibiotics. The patient is prescribed drugs of the following groups:.

Groups of antibiotics.

Drug names.

Penicillins.

Benzylpenicillin, Amoxicillin, Augmentin, Amoxiclav, Amoxil.

Cephalosporins.

Emsef, Ceftriaxone, Cefazolin, Efmerin.

macrolides.

Azithromycin, Clarithromycin (usually prescribed in combination with penicillins).

Initially, antibiotics are administered as intramuscular or intravenous injections.. In severe forms of the disease, solutions in the form of droppers are used.. After 3-4 days, after the patient's condition improves, the patient is transferred to antibiotics in the form of tablets or suspension. The course of treatment is 2-3 weeks.

Auxiliary methods of drug therapy To reduce body temperature and reduce pain, non-steroidal anti-inflammatory drugs based on ibuprofen, nimesulide or paracetamol are prescribed. They are used in the form of tablets or solutions 2-3 times a day after meals..

In addition to antibiotics, symptomatic drugs are prescribed. In case of severe intoxication, detoxification solutions are indicated: Rheosorbilact, Reopoliglyukin. Saline solutions or glucose are also used.

Eliminate swelling and reduce inflammation with corticosteroids. Hormonal drugs (Dexamethasone, Prednisolone) are used in the form of tablets or injections. In severe cases, they are administered intravenously..

Expectorants are shown to thin and remove sputum (Ambroxol, ACC, Carbocysteine). They can be given as tablets, injections, or inhalations..

Alternative methods of treating pneumonia at homeIn the complex treatment of the disease, folk remedies are used:.

decoction of flax seeds. To prepare the product, two tablespoons of dry raw materials are poured into 1 liter of water and boiled over low heat for at least 5 minutes.. Then the broth is removed from the heat, poured into a thermos and left for 5-6 hours.. Take the drug 100 ml 4 times a day. Treatment continues until the patient's condition improves.;

parsley seed decoction. One tablespoon of plant seeds is poured into 1/2 liter of water and boiled over low heat for 20 minutes. After the product has cooled down, it is filtered and taken one tablespoon 4 times a day.;

lovage root decoction. To prepare it, 50 g of dry raw materials are poured into 1 liter of water and boiled for 10 minutes.. In the future, the product is infused in a warm place for 2 hours.. Filter and consume 50 ml three times a day before meals.;

viburnum infusion. To prepare it, 1/2 cup of fresh viburnum berries is poured into 1 liter of boiling water and insisted for 5 hours. Then the agent is filtered and given to the patient 200 ml three times a day.. You can add honey to improve the taste.;

sea \u200b\u200bbuckthorn and honey mixture. A glass of sea buckthorn berries is crushed with a blender and the same amount of honey is added. The patient is given one tablespoon of the drug three times a day before meals..

Prevention: Bedridden patients need to pay special attention to methods for preventing the development of pneumonia:.

semi-sitting;

change body position at least 4 times a day;

do massage (can, percussion).

It is important to try to give the patient a semi-sitting position. In order to prevent the development of congestive pneumonia, it is necessary to monitor the patient's diet. His diet should contain enough vitamins and minerals.. If a person has a poor appetite, he is shown vitamin complexes.

Breathing exercises as a method of preventing congestive pneumoniaAnother method of preventing congestive pneumonia is breathing exercises. This is a vital procedure on which rehabilitation depends..

Respiratory gymnastics has a general tonic effect, positively affects the mental state of the patient, and also allows you to:.

prevent lung muscle atrophy;

restore lung function after an illness;

stimulate the functions of the cardiovascular system;

prevent the occurrence of blood clots and the development of pathologies of the urinary system.

In order to prevent the development of congestive pneumonia, the patient must perform the following exercises:.

while inhaling, the patient raises his arms up and hugs his shoulders, and on exhalation returns to the starting position (performed lying on his back);

while inhaling, the patient raises his hands with palms up, while exhaling lowers them along the body;

the patient performs head turns in both directions simultaneously with short inhalations and exhalations;

the patient clenches his hands into fists and puts them to his belt, on inspiration he sharply lowers down, and on exhalation he returns to his original position.

Inflating balloons, blowing air into a tube placed in a glass of water also has a good effect (it allows you to ventilate the lower sections of the lungs).

All exercises should be done smoothly and slowly, without overstraining the muscles of the chest.. If the patient is tired or his condition worsens, classes should be stopped..

Prognosis The prognosis for developed congestive pneumonia depends on which part of the lungs is affected by the inflammatory process, what exactly caused the disease and at what stage the inflammation was detected. The presence of comorbidities is also taken into account..

If the disease is detected on time, and the prescribed treatment gives the desired effect, then the prognosis is favorable.. In severe forms of the disease, death is possible. Therefore, if you suspect the development of congestive pneumonia, it is necessary to show the bedridden patient to the doctor as soon as possible..

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