В публикации рассматриваются вопросы адъювантной (неантимикробной) терапии при внебольничной пневмонии. Приводится анализ эффективности применения различных лекарственных средств (муколитики, нестероидные противовоспалительные препараты, системные глюкокортикостероиды, иммуноглобулины и пр.) и аппаратных методов воздействия на грудную клетку при внебольничной пневмонии, даются рекомендации по их клиническому применению.
The publication deals with the adjuvant (non-antimicrobial) therapy for community-acquired pneumonia. The analysis of the effectiveness of various drugs (mucolytics, non-steroidal anti-inflammatory drugs, systemic corticosteroids, immunoglobulins, etc..) And as for the hardware methods of exposure to the chest in community-acquired pneumonia are given recommendations for their clinical use.
1. Mandell L, Wunderink R, Anzueto A et al. Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults. Clin Infect Dis 2007; 44 (Suppl. 2): S27–72.
2. Woodhead M, Blasi F, Ewig S et al. Guidelines for the management of adult lower respiratory tract infections. Clin Microbiol Infect 2011; 17 (Suppl. 6): E1–59.
3. Чучалин А.Г., Синопальников А.И., Козлов Р.С. и др. Внебольничная пневмония у взрослых. Практические рекомендации по диагностике, лечению и профилактике. М., 2010. / Chuchalin A.G., Sinopal'nikov A.I., Kozlov R.S. i dr. Vnebol'nichnaia pnevmoniia u vzroslykh. Prakticheskie rekomendatsii po diagnostike, lecheniiu i profilaktike. M., 2010. [in Russian]
4. Овчинников Ю.В., Зайцев А.А., Синопальников А.И. и др. Внебольничная пневмония у военнослужащих: тактика ведения и антимикробная терапия. Воен.-мед. журн. 2016; 3: 4–14. / Ovchinnikov Iu.V., Zaitsev A.A., Sinopal'nikov A.I. i dr. Vnebol'nichnaia pnevmoniia u voennosluzhashchikh: taktika vedeniia i antimikrobnaia terapiia. Voen.-med. zhurn. 2016; 3: 4–14. [in Russian]
5. Siempos I, Vardakas K, Kopterides P, Falagas M. Adjunctive therapies for community acquired pneumonia: a systematic review. J Antimicrob Chemother 2008; 62: 661–68.
6. Белевский А.С. Современные возможности адъювантной терапии внебольничной пневмонии. Фарматека. 2013; 6 (259): 49–52. / Belevskii A.S. Sovremennye vozmozhnosti ad"iuvantnoi terapii vnebol'nichnoi pnevmonii. Farmateka. 2013; 6 (259): 49–52. [in Russian]
7. Siemieniuk R, Meade M, Alonso-Coello P et al. Corticosteroid therapy for patients hospitalized with community-acquired pneumonia: a systematic review and meta-analysis. Ann Intern Med 2015; 163: 519–28.
8. Polverino E, Cillóniz C, Dambrava P et al. Systemic corticosteroids for Community Acquired Pneumonia: reasons for use and lack of benefit on outcome. Respirology 2013; 18 (2): 263–71.
9. Смоленов И.В., Алексеева Я.Г., Смирнов Н.А. Роль неантибактериальных лекарственных средств в лечении пневмонии. Клин. микробиология, антимикробная химиотер. 2002; 3: 233–8. / Smolenov I.V., Alekseeva Ia.G., Smirnov N.A. Rol' neantibakterial'nykh lekarstvennykh sredstv v lechenii pnevmonii. Klin. mikrobiologiia, antimikrobnaia khimioter. 2002; 3: 233–8. [in Russian]
10. Зайцев А.А., Оковитый С.В. Кашель: дифференциальный диагноз и рациональная фармакотерапия. Тер. архив. 2014; 86 (12): 85–91. / Zaitsev A.A., Okovityi S.V. Kashel': differentsial'nyi diagnoz i ratsional'naia farmakoterapiia. Ter. arkhiv. 2014; 86 (12): 85–91 [in Russian]
11. Сёмаш Н.А., Тюрин И.Е., Белевский А.С., Вязьменова Н.И. Высокие дозы N-ацетилцистеина при внебольничной пневмонии. Лечебное дело. 2012; 2: 81–6. / Semash N.A., Tiurin I.E., Belevskii A.S., Viaz'menova N.I. Vysokie dozy N-atsetiltsisteina pri vnebol'nichnoi pnevmonii. Lechebnoe delo. 2012; 2: 81–6. [in Russian]
12. Laurent T, Markert M, Feihl F et al. Oxidant-antioxidant balance in granulocytes during ARDS. Effect of N-acetylcysteine. Chest 1996; 1 (109): 163–6.
13. Suter P, Domenighetti G, Schaller M et al. N-acetylcysteine enhances recovery from acute lung injury in man. A randomized, double-blind, placebo-controlled clinical study. Chest 1994; 1 (105): 190–4.
14. Moradi M, Mojtahedzadeh M, Mandegari A et al. The role of glutathione-S-transferase polymorphisms on clinical outcome of ALI/ARDS patient treated with N-acetylcysteine. Respir Med 2009; 3 (103): 434–41.
15. Авдеев С.Н., Батын С.З., Мержоева З.М. и др. Высокие дозы N-ацетилцистеина при остром респираторном дистресс-синдроме. Вестн. анестезиологии и реаниматологии. 2010; 5: 3–11. / Avdeev S.N., Batyn S.Z., Merzhoeva Z.M. i dr. Vysokie dozy N-atsetiltsisteina pri ostrom respiratornom distress-sindrome. Vestn. anesteziologii i reanimatologii. 2010; 5: 3–11. [in Russian]
16. Авдеев С.Н., Карчевская Н.А., Баймаканова Г.Е. и др. Годичное наблюдение за больными, перенесшими острое повреждение легких/острый респираторный дистресс-синдром, вызванный вирусом гриппа А/H1N1. Пульмонология. 2011; 4: 58–66. / Avdeev S.N., Karchevskaia N.A., Baimakanova G.E. i dr. Godichnoe nabliudenie za bol'nymi, perenesshimi ostroe povrezhdenie legkikh/ostryi respiratornyi distress-sindrom, vyzvannyi virusom grippa A/H1N1. Pul'monologiia. 2011; 4: 58–66. [in Russian]
17. Antonaglia V, Lucangelo U, Zin WA et al. Intrapulmonary percussive ventilation improves the outcome of patients with acute exacerbation of chronic obstructive pulmonary disease using a helmet. Crit Care Med 2006; 34: 2940–5.
18. Clini EM, Antoni FD, Vitacca M et al. Intra-pulmonary percussive ventilation in tracheostomised patients: a randomised controlled trial. Int Care Med 2006; 32: 1994–2001.
19. Иванов В.В., Харитонов М.А., Журкин М.А. и др. Применение вибрационно-компрессионного воздействия на грудную клетку при внебольничной пневмонии. Вестн. Российской военно-медицинской академии. 2015; 3 (51): 72–7. / Ivanov V.V., Kharitonov M.A., Zhurkin M.A. i dr. Primenenie vibratsionno-kompressionnogo vozdeistviia na grudnuiu kletku pri vnebol'nichnoi pnevmonii. Vestn. Rossiiskoi voenno-meditsinskoi akademii. 2015; 3 (51): 72–7. [in Russian]
20. Jean D, Maitre B, Tankovic J et al. Beneficial effects of nitric oxide inhalation on pulmonary bacterial clearance. Crit Care Med 2002; 30: 442–7.
21. Hunt J, Bronicki R, Anas N. Role of Inhaled Nitric Oxide in the Management of Severe Acute Respiratory Distress Syndrome. Front Ped 2016; 2 (4): 74.
22. Siobal M, Hess D. Are inhaled vasodilators useful in acute lung injury and acute respiratory distress syndrome? Respir Care 2010; 55(2): 144–57.
23. Tonnellier M, Ferrari F, Goldstein I et al. Intravenous versus nebulized ceftazidime in ventilated piglets with and without experimental bronchopneumonia: comparative effects of helium and nitrogen. Anesthesiology 2005; 102: 995–1000.
24. Красновский А.Л., Григорьев С.П., Золкина И.В. и др. Применение подогреваемой кислородно-гелиевой смеси в комплексном лечении пациентов с внебольничной пневмонией. Клин. мед. 2013; 5 (91): 38–41. / Krasnovskii A.L., Grigor'ev S.P., Zolkina I.V. i dr. Primenenie podogrevaemoi kislorodno-gelievoi smesi v kompleksnom lechenii patsientov s vnebol'nichnoi pnevmoniei. Klin. med. 2013; 5 (91): 38–41. [in Russian]
25. Стец В.В. Из доклада на Всеармейской конференции «Внебольничная пневмония у военнослужащих» 04.02.2014 г., ГВКГ им. Н.Н.Бурденко. / Stets V.V. Iz doklada na Vsearmeiskoi konferentsii “Vnebol'nichnaia pnevmoniia u voennosluzhashchikh” 04.02.2014 g., GVKG im. N.N.Burdenko. [in Russian]
26. Yilmaz S, Daglioglu K, Yildizdas D et al. The effectiveness of heliox in acute respiratory distress syndrome. Ann Thorac Med 2013; 8 (1): 46–52.
27. Зайцев А.А., Синопальников А.И. Дифференциальная диагностика при синдроме затяжной пневмонии. Справочник поликлинического врача. 2015; 10: 6–19. / Zaitsev A.A., Sinopal'nikov A.I. Differentsial'naia diagnostika pri sindrome zatiazhnoi pnevmonii. Spravochnik poliklinicheskogo vracha. 2015; 10: 6–19. [in Russian]
28. Иванов В.В., Овчинников Ю.В., Данцев В.В. и др. Клинический случай сочетания тяжелой вирусно-бактериальной пневмонии и инфильтративного туберкулеза легких у военнослужащего. Воен.-мед. журн. 2015; 336 (5): 53–6. / Ivanov V.V., Ovchinnikov Iu.V., Dantsev V.V. i dr. Klinicheskii sluchai sochetaniia tiazheloi virusno-bakterial'noi pnevmonii i infil'trativnogo tuberkuleza legkikh u voennosluzhashchego. Voen.-med. zhurn. 2015; 336 (5): 53–6. [in Russian]
29. Чучалин А.Г., Синопальников А.И., Козлов Р.С. и др. Клинические рекомендации по диагностике, лечению и профилактике тяжелой внебольничной пневмонии у взрослых. М.: М-Вести, 2014. / Chuchalin A.G., Sinopal'nikov A.I., Kozlov R.S. i dr. Klinicheskie rekomendatsii po diagnostike, lecheniiu i profilaktike tiazheloi vnebol'nichnoi pnevmonii u vzroslykh. M.: M-Vesti, 2014. [in Russian]
30. Lissner R, Struff W, Autenrieth I et al. Efficacy and potential clinical applications of Pentaglobin, and IgM entriched immunoglobulin concentrate suitable for intravenous infusion. Eur J Surg 1999; 584: 17–25.
31. Nelson S. Novel nonantibiotic therapies for pneumonia: cytokines and host defense. Chest 2001; 119: 419–25.
32. Alejandria M, Lansang M, Dans L, Mantaring J. Intravenous immunoglobulin for treating sepsis, severe sepsis and septic shock. Cochrane Database Syst Rev 2013; 16 (9). CD001090.
33. Smith WS, Sumnicht GE, Sharpe RW et al. Granulocyte colony_stimulating factor versus placebo in addition to Penicillin G in a randomized blinded study of Gram_negative pneumonia sepsis: analysis of survival and multisystem organ failure. Blood 1995; 86: 1301–9.
34. Nelson S, Farkas S, Fotheringham N et al. Filgrastim in the treatment of hospitalized patients with community-acquired pneumonia (CAP). Am J Respir Crit Care Med 1996; 153: 535.
35. Polverino E, Cillóniz C, Dambrava P et al. Systemic corticosteroids for Community Acquired Pneumonia: reasons for use and lack of benefit on outcome. Respirology 2012; 18: 263–71.
36. Blum C, Nigro N, Briel M et al. Adjunct prednisone therapy for patients with community-acquired pneumonia: a multicentre, double-blind, randomised, placebo-controlled trial. Lancet 2015; 385: 1511–8.
37. Torres A, Sibila O, Ferrer M et al. Effect of corticosteroids on treatment failure among hospitalized patients with severe community-acquired pneumonia and high inflammatory response: a randomized clinical trial. JAMA 2015; 313: 677–86.
38. Siemieniuk R, Meade MO, Alonso-Coello P et al. Corticosteroid therapy for patients hospitalized with community-acquired pneumonia: a systematic review and meta-analysis. Ann Int Med 2015; 163: 519–28.
39. Feldman C, Anderson R. Corticosteroids in the adjunctive therapy of community-acquired pneumonia: an appraisal of recent meta-analyses of clinical trials. J Thorac Dis 2016; 8 (3): E162–E171.
40. Forceville X, Vitoux D., Gauzit R et al. Selenium, systemic immune response syndrome, sepsis, and outcome in critically ill patients. Crit Care Med 1998; 26 (9): 1536–44.
41. Angstwurm M, Schottdortf J, Schopohl J, Caertner R. Selenium replacement with severe systemic inflammatory response syndrome improves clinical outcom. Crit Care Med 1999; 27 (9): 1807–13.
42. Орлов А.М., Бакулин И.Г., Мазо В.К. Недостаточность селена при пневмонии: случайность или закономерность? проблема гастроэнтерологии или нутрициологии? Экспер. и клин. гастроэнтерология. 2013; 2: 20–7. / Orlov A.M., Bakulin I.G., Mazo V.K. Nedostatochnost' selena pri pnevmonii: sluchainost' ili zakonomernost'? problema gastroenterologii ili nutritsiologii? Eksper. i klin. gastroenterologiia. 2013; 2: 20–7 [in Russian]
43. Alhazzani W, Jacobi J, Sindi A et al. The effect of selenium therapy on mortality in patients with sepsis syndrome: a systematic review and meta-analysis of randomized controlled trials. Crit Care Med 2013; 41 (6): 1555–64.
44. Kong Z, Wang F, Ji S et al. Selenium supplementation for sepsis: a meta-analysis of randomized controlled trials. Am J Emerg Med 2013; 31 (8): 1170–5.
45. Chelkeba L, Ahmadi A, Abdollahi M et al. The effect of parenteral selenium on outcomes of mechanically ventilated patients following sepsis: a prospective randomized clinical trial. Ann Intensive Care 2015; 5 (1): 29.
________________________________________________
1. Mandell L, Wunderink R, Anzueto A et al. Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults. Clin Infect Dis 2007; 44 (Suppl. 2): S27–72.
2. Woodhead M, Blasi F, Ewig S et al. Guidelines for the management of adult lower respiratory tract infections. Clin Microbiol Infect 2011; 17 (Suppl. 6): E1–59.
3. Chuchalin A.G., Sinopal'nikov A.I., Kozlov R.S. i dr. Vnebol'nichnaia pnevmoniia u vzroslykh. Prakticheskie rekomendatsii po diagnostike, lecheniiu i profilaktike. M., 2010. [in Russian]
4. Ovchinnikov Iu.V., Zaitsev A.A., Sinopal'nikov A.I. i dr. Vnebol'nichnaia pnevmoniia u voennosluzhashchikh: taktika vedeniia i antimikrobnaia terapiia. Voen.-med. zhurn. 2016; 3: 4–14. [in Russian]
5. Siempos I, Vardakas K, Kopterides P, Falagas M. Adjunctive therapies for community acquired pneumonia: a systematic review. J Antimicrob Chemother 2008; 62: 661–68.
6. Belevskii A.S. Sovremennye vozmozhnosti ad"iuvantnoi terapii vnebol'nichnoi pnevmonii. Farmateka. 2013; 6 (259): 49–52. [in Russian]
7. Siemieniuk R, Meade M, Alonso-Coello P et al. Corticosteroid therapy for patients hospitalized with community-acquired pneumonia: a systematic review and meta-analysis. Ann Intern Med 2015; 163: 519–28.
8. Polverino E, Cillóniz C, Dambrava P et al. Systemic corticosteroids for Community Acquired Pneumonia: reasons for use and lack of benefit on outcome. Respirology 2013; 18 (2): 263–71.
9. Smolenov I.V., Alekseeva Ia.G., Smirnov N.A. Rol' neantibakterial'nykh lekarstvennykh sredstv v lechenii pnevmonii. Klin. mikrobiologiia, antimikrobnaia khimioter. 2002; 3: 233–8. [in Russian]
10. Zaitsev A.A., Okovityi S.V. Kashel': differentsial'nyi diagnoz i ratsional'naia farmakoterapiia. Ter. arkhiv. 2014; 86 (12): 85–91 [in Russian]
11. Semash N.A., Tiurin I.E., Belevskii A.S., Viaz'menova N.I. Vysokie dozy N-atsetiltsisteina pri vnebol'nichnoi pnevmonii. Lechebnoe delo. 2012; 2: 81–6. [in Russian]
12. Laurent T, Markert M, Feihl F et al. Oxidant-antioxidant balance in granulocytes during ARDS. Effect of N-acetylcysteine. Chest 1996; 1 (109): 163–6.
13. Suter P, Domenighetti G, Schaller M et al. N-acetylcysteine enhances recovery from acute lung injury in man. A randomized, double-blind, placebo-controlled clinical study. Chest 1994; 1 (105): 190–4.
14. Moradi M, Mojtahedzadeh M, Mandegari A et al. The role of glutathione-S-transferase polymorphisms on clinical outcome of ALI/ARDS patient treated with N-acetylcysteine. Respir Med 2009; 3 (103): 434–41.
15. Avdeev S.N., Batyn S.Z., Merzhoeva Z.M. i dr. Vysokie dozy N-atsetiltsisteina pri ostrom respiratornom distress-sindrome. Vestn. anesteziologii i reanimatologii. 2010; 5: 3–11. [in Russian]
16. Avdeev S.N., Karchevskaia N.A., Baimakanova G.E. i dr. Godichnoe nabliudenie za bol'nymi, perenesshimi ostroe povrezhdenie legkikh/ostryi respiratornyi distress-sindrom, vyzvannyi virusom grippa A/H1N1. Pul'monologiia. 2011; 4: 58–66. [in Russian]
17. Antonaglia V, Lucangelo U, Zin WA et al. Intrapulmonary percussive ventilation improves the outcome of patients with acute exacerbation of chronic obstructive pulmonary disease using a helmet. Crit Care Med 2006; 34: 2940–5.
18. Clini EM, Antoni FD, Vitacca M et al. Intra-pulmonary percussive ventilation in tracheostomised patients: a randomised controlled trial. Int Care Med 2006; 32: 1994–2001.
19. Ivanov V.V., Kharitonov M.A., Zhurkin M.A. i dr. Primenenie vibratsionno-kompressionnogo vozdeistviia na grudnuiu kletku pri vnebol'nichnoi pnevmonii. Vestn. Rossiiskoi voenno-meditsinskoi akademii. 2015; 3 (51): 72–7. [in Russian]
20. Jean D, Maitre B, Tankovic J et al. Beneficial effects of nitric oxide inhalation on pulmonary bacterial clearance. Crit Care Med 2002; 30: 442–7.
21. Hunt J, Bronicki R, Anas N. Role of Inhaled Nitric Oxide in the Management of Severe Acute Respiratory Distress Syndrome. Front Ped 2016; 2 (4): 74.
22. Siobal M, Hess D. Are inhaled vasodilators useful in acute lung injury and acute respiratory distress syndrome? Respir Care 2010; 55(2): 144–57.
23. Tonnellier M, Ferrari F, Goldstein I et al. Intravenous versus nebulized ceftazidime in ventilated piglets with and without experimental bronchopneumonia: comparative effects of helium and nitrogen. Anesthesiology 2005; 102: 995–1000.
24. Krasnovskii A.L., Grigor'ev S.P., Zolkina I.V. i dr. Primenenie podogrevaemoi kislorodno-gelievoi smesi v kompleksnom lechenii patsientov s vnebol'nichnoi pnevmoniei. Klin. med. 2013; 5 (91): 38–41. [in Russian]
25. Stets V.V. Iz doklada na Vsearmeiskoi konferentsii “Vnebol'nichnaia pnevmoniia u voennosluzhashchikh” 04.02.2014 g., GVKG im. N.N.Burdenko. [in Russian]
26. Yilmaz S, Daglioglu K, Yildizdas D et al. The effectiveness of heliox in acute respiratory distress syndrome. Ann Thorac Med 2013; 8 (1): 46–52.
27. Zaitsev A.A., Sinopal'nikov A.I. Differentsial'naia diagnostika pri sindrome zatiazhnoi pnevmonii. Spravochnik poliklinicheskogo vracha. 2015; 10: 6–19. [in Russian]
28. Ivanov V.V., Ovchinnikov Iu.V., Dantsev V.V. i dr. Klinicheskii sluchai sochetaniia tiazheloi virusno-bakterial'noi pnevmonii i infil'trativnogo tuberkuleza legkikh u voennosluzhashchego. Voen.-med. zhurn. 2015; 336 (5): 53–6. [in Russian]
29. Chuchalin A.G., Sinopal'nikov A.I., Kozlov R.S. i dr. Klinicheskie rekomendatsii po diagnostike, lecheniiu i profilaktike tiazheloi vnebol'nichnoi pnevmonii u vzroslykh. M.: M-Vesti, 2014. [in Russian]
30. Lissner R, Struff W, Autenrieth I et al. Efficacy and potential clinical applications of Pentaglobin, and IgM entriched immunoglobulin concentrate suitable for intravenous infusion. Eur J Surg 1999; 584: 17–25.
31. Nelson S. Novel nonantibiotic therapies for pneumonia: cytokines and host defense. Chest 2001; 119: 419–25.
32. Alejandria M, Lansang M, Dans L, Mantaring J. Intravenous immunoglobulin for treating sepsis, severe sepsis and septic shock. Cochrane Database Syst Rev 2013; 16 (9). CD001090.
33. Smith WS, Sumnicht GE, Sharpe RW et al. Granulocyte colony_stimulating factor versus placebo in addition to Penicillin G in a randomized blinded study of Gram_negative pneumonia sepsis: analysis of survival and multisystem organ failure. Blood 1995; 86: 1301–9.
34. Nelson S, Farkas S, Fotheringham N et al. Filgrastim in the treatment of hospitalized patients with community-acquired pneumonia (CAP). Am J Respir Crit Care Med 1996; 153: 535.
35. Polverino E, Cillóniz C, Dambrava P et al. Systemic corticosteroids for Community Acquired Pneumonia: reasons for use and lack of benefit on outcome. Respirology 2012; 18: 263–71.
36. Blum C, Nigro N, Briel M et al. Adjunct prednisone therapy for patients with community-acquired pneumonia: a multicentre, double-blind, randomised, placebo-controlled trial. Lancet 2015; 385: 1511–8.
37. Torres A, Sibila O, Ferrer M et al. Effect of corticosteroids on treatment failure among hospitalized patients with severe community-acquired pneumonia and high inflammatory response: a randomized clinical trial. JAMA 2015; 313: 677–86.
38. Siemieniuk R, Meade MO, Alonso-Coello P et al. Corticosteroid therapy for patients hospitalized with community-acquired pneumonia: a systematic review and meta-analysis. Ann Int Med 2015; 163: 519–28.
39. Feldman C, Anderson R. Corticosteroids in the adjunctive therapy of community-acquired pneumonia: an appraisal of recent meta-analyses of clinical trials. J Thorac Dis 2016; 8 (3): E162–E171.
40. Forceville X, Vitoux D., Gauzit R et al. Selenium, systemic immune response syndrome, sepsis, and outcome in critically ill patients. Crit Care Med 1998; 26 (9): 1536–44.
41. Angstwurm M, Schottdortf J, Schopohl J, Caertner R. Selenium replacement with severe systemic inflammatory response syndrome improves clinical outcom. Crit Care Med 1999; 27 (9): 1807–13.
42. Orlov A.M., Bakulin I.G., Mazo V.K. Nedostatochnost' selena pri pnevmonii: sluchainost' ili zakonomernost'? problema gastroenterologii ili nutritsiologii? Eksper. i klin. gastroenterologiia. 2013; 2: 20–7 [in Russian]
43. Alhazzani W, Jacobi J, Sindi A et al. The effect of selenium therapy on mortality in patients with sepsis syndrome: a systematic review and meta-analysis of randomized controlled trials. Crit Care Med 2013; 41 (6): 1555–64.
44. Kong Z, Wang F, Ji S et al. Selenium supplementation for sepsis: a meta-analysis of randomized controlled trials. Am J Emerg Med 2013; 31 (8): 1170–5.
45. Chelkeba L, Ahmadi A, Abdollahi M et al. The effect of parenteral selenium on outcomes of mechanically ventilated patients following sepsis: a prospective randomized clinical trial. Ann Intensive Care 2015; 5 (1): 29.
Авторы
А.А.Зайцев*
ФГКУ Главный военный клинический госпиталь им. акад. Н.Н.Бурденко Минобороны России. 105229, Россия, Москва, Госпитальная пл., д. 3
*a-zaicev@yandex.ru
________________________________________________
A.A.Zaytsev*
N.N.Burdenko Main Military Clinical Hospital of the Ministry of Defense of the Russian. 105229, Russian Federation, Moscow, Gospital'naia pl., d. 3
*a-zaicev@yandex.ru