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19.05.2005 N 274 " "

10 2009



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(J14)                     , ,       :      /                                    
                          , ,       ,        30                           
                                            3 /,                                
                           .     1 - 2  ,                                        
                                 .        2 - 5                           
                                                   20% - 3 - 4 /,                          
                                                                                                
                                                             0,25 - 0,5 - 2                            
                          :                                      /                                          
                          ,                                                                                    
                                                                                                           
                          , .                                                                                
                                                                                                         
               +-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
                          +                                        :                        
                                 1                       0,75 - 1,5                             
                                                                  3 - 4 / /                             
                                  1                      /                         
                                                            500/125  - 2 -                          
                                                        3 /  (                            
                                                              ).                                 
                                     1                       -                                 
                                                             15 - 20                                  
                                                            // /                                     
                                                                30                           
                          :                                     3 /,                                
                          ,                                                                    
                          ,                                  2 - 5                           
                                                      20% - 3 - 4 /,                          
                                                                                                         
                                                                         0,25 - 0,5 - 2                            
                                                                        /                                          
+---------------+-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
,     ,       .                        15 .    
 -                                                                 
                        .                                         
            :             (                                
(J15 - 16)                , ,       :      ):  15 - 20                          
                          , ,       ,      / 1 /  /                            
                                            3-                                
                           .     1 - 2  ,   :                             
                                 .      1 - 2  - 1 / /                           
                                                                                         
                                                                -                                    
                                                             0,5 - 1                               
                          :                                      /   /                            
                          ,                                    30                           
                                                          3 /,                                
                          , .                                                                   
                                                         2 - 5                           
                                                                        20% - 3 - 4 /,                          
                                                                                                         
                                                                         0,25 - 0,5 - 2                            
                                                                        /                                          
               +-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
                          +                                                                
                                 1                                                              
                                                                                                      
                                  1                      (                                
                                                           ):  15 - 20                          
                                                        / 1 /  /                            
                                                              3 - 4                               
                                     1                      :                             
                                                            1 - 2  - 1 / /                           
                                                              1 - 2  - 2                           
                                                              / /,                                  
                          :                                      -                          
                          ,                                0,5 - 1                               
                          ,                                /   /                            
                                                        -                             
                                                                         0,5  / 2 -                          
                                                                        4 /                                        
                                                                          30                           
                                                                         3 /,                                
                                                                                                             
                                                                          2 - 5                           
                                                                        20% - 3 - 4 /,                          
                                                                                                         
                                                                         0,25 - 0,5 - 2                            
                                                                        /                                          
+---------------+-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
   ,       .                   5 - 7 .  
                                                             
                      .                                  
(J18)                     :               -                                
                          , ,       :                                      
                          , ,       ,                                               
                                                                       
                           .     1 - 2  ,                                      
                                 .       (. J12 - 16)                          
                                                                                                     
                                                                                                                 
                                                                                                              
                          :                                                                                        
                          ,                                                                                    
                                                                                                           
                          , .                                                                                
                                                                                                         
               +-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
                          +                                                                         
                                 1                                                                        
                                                                                                                    
                                  1                                                                        
                                                                                                             
                                                                                                          
                                                                                                               
                                     1                                                                        
                                                                                                              
                                                                                                              
                                                                                                                
                          :                                                                                      
                          ,                                                                                 
                          ,                                                                                  
                                                                                                        
+---------------+-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
          ,                                         10 - 15 .      
()                                      :  - 60 -                            
(J45)                      .       1 - 2          80%  ,                                 
                                  1 - 2                                         
                                    1 - 2                     ,                            
                                  1 - 2                    ,                                 
                          :                                   ,  - 100 -                              
                                                           120/, SaO2 - 91 - 95%                          
                                                                     2-                              
                                                          :                               
                                                         2,5 - 5                                      
                          ,                                                                
                                                                                        
                                                        500  (2                               
                                                                  -,  250                             
                                                                        /)                            
                                                                                                               
                                                                        :                             
                                                                         0,5 - 1,0                             
                                                                        //   /                          
                                                                                                      
                                                                         ,                            
                                                                                                         
                                                                        ""  7                               
                                                                        / (                                      
                                                                                                        
                                                                          250 )                          
                                                                          20 ,                            
                                                                                                           
                                                                                                        
                                                                        0,5 - 1,0 //.                              
                                                                                                      
                                                                         ,                           
                                                                         ""                                  
                                                                        :                              
                                                                                                      
                                                                          0,5 - 1,0                                 
                                                                        //                                         
                                                                         :                            
                                                                        <60%  .                            
                                                                                                         
                                                                        : ,                                    
                                                                         ,                            
                                                                         > 30/,                              
                                                                                                    
                                                                        , ,                           
                                                                        ,  >120/,                            
                                                                        SaO2 <90%, 40 - 60%.                              
                                                                         (                            
                                                                         ),                          
                                                                                                    
                                                                         2,5 - 5                               
                                                                        .                            
                                                                        0,5 - 1 //                           
                                                                         /,                                       
                                                                         200                               
                                                                        /.                              
                                                                         - /                               
                                                                                                         
                                                                           240                           
                                                                         (                                 
                                                                                                          
                                                                        )                                           
                                                                        :                                    
                                                                                                     
                                                                        2-                          
                                                                                                     
                                                                         .                                 
                                                                         .                                
                                                                          -                               
                                                                                                         
                                                                                                       
                                                                         ( -                               
                                                                        ),                                    
                                                                                                                
                                                                                                   
                                                                         ( - ).                             
                                                                                                          
                                                                         -                              
                                                                                                     
                                                                         800  1000 / (                         
                                                                                                      
                                                                        ),                           
                                                                                                               
                                                                         2-                           
                                                                        :                            
                                                                                                                 
                                                                        (/) 1 - 2                         
                                                                         2 /                                  
               +-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
                          +                                                                             
                                  1                                                                        
                                     1                                                                        
                                                                                                                
                                                                                                                
                                                                                                             
               +-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
               .                                             +                                   
                                                                                                       
                                                                                                                
                                                                                                             
                                                                                                    
                                                                                                          
+---------------+-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
 (J43) ,       .      2                     15 .         
                           .                         :                            
                                                 20                                     
                                                                                  
             :                               - 0,5                          
                  -                              (2 )  30                            
                                                         1,5                              
(                                               ,   2 - 4                          
                    .                                  ,                           
)                                                          -                            
(J44)                     R-                                                                 
                                                           ( 250  /)                          
                                                                            200                          
                                                                         1 - 3 /                             
                                                                                                      
                                                                         20 / 2 - 4                              
                                                                         3 - 4 /                               
                                                                        :  30                          
                                                                         3 /                               
                                                                                                                 
                                                                                                    
                                                                          ( -                           
                                                                         1) <50%                             
                                                                                                                 
                                                                                                    
                                                                        ( - )                                  
                                                                         :                            
                                                                                                    
                                                                        2 - 4 / 10 - 14                           
                                                                                                      
                                                                        30 / 10 - 14                             
                                                                                                      
                                                                           2 - 3                              
                                                                        .,                             
                                                                                                     
                                                                                                           
                                                                        :                             
                                                                           (800                               
                                                                        /)                                          
                                                                                                        
                                                                                                    
                                                                        .                                  
                                                                                                           
                                                                         -                                      
                                                                        ,                                  
                                                                         -                                
                                                                                                                
                                                                        .                                     
                                                                         :                               
                                                                                                      
                                                                                                     
                                                                          18 .                                
                                                                                                         
                                                                        :                            
                                                                        2,5    1                            
                                                                                                                        
                                                                                                          
                                                                                                            
                                                                                                     
                                                                        :                                     
                                                                          5 /                          
                                                                            30                           
                                                                        ,                                         
                                                                                                        
                                                                        0,4 - 0,5 //                               
                                                                                                                 
                                                                        :                             
                                                                         40 - 80                          
                                                                                                        
                                                                        100 - 200   6                             
                                                                         /   48                             
                                                                                                         
                                                                                                             
                                                                                                               
                                                                                                             
                                                                         ( -                          
                                                                        ).                                             
                                                                                                         
                                                                                                        
                                                                                                     
                                                                        .                               
                                                                          -                              
                                                                        H.influenzae,                                     
                                                                        S.pneumoniae,                             
                                                                         -                                         
                                                                        Enterobacteriaceae,                               
                                                                        P.aeruginosa,                              
                                                                                                              
                                                                                                           
                                                                         3-                                
                                                                         (),                           
                                                                         /                                   
                                                                        ()                                     
                                                                                                    
                                                                           >25/,                            
                                                                        2 > 45  .., ph                          
                                                                        <7,35, 2/FiO2 <200                             
                                                                         ..                               
                                                                                                          
                                                                        :                               
                                                                        ,                              
                                                                                                              
                                                                        (                                    
                                                                                                      
                                                                        ( - ) <70  .                           
                                                                        .,  <50 /.                             
                                                                        >160/.),  >35/,                           
                                                                        ph                                    
                                                                         <7,25, 2 <45                           
                                                                        ..,                                 
                                                                                                                
                                                                        )                                  
                                                                                                   
                                                                                                          
                                                                         -                              
                                                                                                      
                                                                         18  1                                 
                                                                        /,                                       
                                                                                                            
                                                                                                     
                                                                           800  1000                               
                                                                        / (                             
                                                                          )                             
                                                                                                     
                                                                        .                             
                                                                        ""                                     
               +-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
               ,          +                                         +                                   
               .      :      1                                                     
                          2, 2, ,                                                                     
                          SO2                                                                                
                                 1                                                         
                                                                                                    
                                      1                                                                        
                                                                                                          
                                                                                                              
+---------------+-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
-        ,       .    1 - 2                  :       14-21       
                                        1  - 2                                
 (J47)                                        / /  /                               
                          :                                 10 - 15                                  
                          , ,                             // /  /                             
                          ,                                      1 - 2                                   
                           .                                                                    
                                                            :                            
                          :                                      30   3 /,                          
                          , .                                100 -                            
                          ,                                        200    3                                
                                                       /                               
                                                                                                
                          -                               ,                              
                                                                                         
                                                                                                     
                                                                                                          
               +-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
               , .   +                                         +                                   
                                 1                                                    
                                                                   2-  -                                 
                                     1                                                         
                                                                                                          
                                                                                                     
+---------------+-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
         ,       .    1 - 2             18 - 30 .      
-             .                         :       -   
               R-                        20 - 30 /                      
 (J84)                                                                     
                                                                                    
                                                            ,                                      
                                                                                                       
                                                                                                        
                                                                        :                                     
                                                                                                            
                                                                        25 //                                
                                                                                                   
                                                                                                      
                                                                                                     
                                                                                                                     
                                                                                                     
                                                                                                               
               +-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
                          +                         +           +                                   
                                     1                                            
                                                                                                   
                                                                                                             
                                                                                                           
                                                                                                          
               +-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
               .                1                                                          
                                 1      : 2,                                                      
                                                  2, , SO2                                                   
                                     1                                                                        
                                   1                                                                        
+---------------+-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
 ,       .    1 - 2        1,0 - 2         21    
                                       / /                            
(J85)                                                  10 - 15                              
                          :                                // /  /                            
                          , ,                             1 - 2                                     
                          , ,                                                                 
                                                                                              
                                                                                            
                                                                                                              
                          :                                                                                        
                                                                                                         
                           , .                                                                                  
                          .                                                                                          
                           .                                                                                   
                          R-                                                                                 
                                                                                                             
               +-----------+------------------+------------+----------------+-------------------------+-----------+--------------+
               ,          +                         +           +                                   
               .            1           1 - 2  2                                 
                                                                  / /                            
                                     1                       /-                             
                                                              -                                
                          (                                   500/125  2 /                             
                                                                                                   
                                                         0,5                              
                                                           / 1 /                                     
                                                          (                                    
                          30 - 60 )                                                                 
                                      2                                                     


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