Pharmacological correction of acid-base balance disorders in children 1 year of age: Master’s thesis For the OQR "Master" in specialty 226 "Pharmacy, industrial pharmacy"

Abstract

The master's thesis analyzes modern literary sources on the etiology, pathogenesis, and epidemiology of homeostasis disorders in childhood in the form of water-electrolyte and acid-base balance; compares changes that occur in diseases of the respiratory system, digestive tract, and nonspecific inflammatory diseases complicated by acidosis and alkalosis in relation to the age-related physiological norm; determines the place of modern instrumental research methods in the diagnosis of these disorders, as well as for assessing the effectiveness and safety of pharmacotherapy aimed at normalizing these indicators; clarifies approaches and standards of treatment and the use of necessary drugs for pathogenetic treatment. Based on the available clinical and laboratory data, a conclusion was made about the predominant presence of signs of respiratory and metabolic acidosis in children, the main mechanisms of acidification of the internal environment and lowering of blood pH were determined, which later served as the basis for the choice of personalized rehydration infusion therapy and its subsequent inclusion in local protocols for providing specialized care at different levels of dehydration. In respiratory acidosis, the protocol included oxygen inhalation support in combination with intravenous administration of saline solution, alkaline solutions (sodium bicarbonate, soda buffer); in metabolic acidosis, saline solutions, sodium bicarbonate solution, and lactated Ringer's solution were used first. Hardware control of minimal volumes of venous or capillary blood (0,5 ml) allows for rapid, dynamic laboratory control of blood pH, partial pressure of oxygen and carbon dioxide, current levels of bicarbonate and lactate in blood plasma, indicators of the power of the entire blood buffer system with control of buffer bases and their deviations, and use them to diagnose the severity of homeostatic complications and monitor the effectiveness and safety of appropriate infusion therapy.