perinatologyРоссийский вестник перинатологии и педиатрииRossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)1027-40652500-2228Ltd. “The National Academy of Pediatric Science and Innovation”perinatology-244Research ArticleВ ПОМОЩЬ ПРАКТИЧЕСКОМУ ВРАЧУFOR THE PRACTITIONERРеспираторно-синцитиальная вирусная инфекция у детей с врожденными пороками сердца: актуальность проблемы и рекомендации по профилактикеRespiratory syncytial virus infection in children with congenital heart defects: Problem relevance and prevention guidelinesБокерияЕ. Л.BockeriaE. L.

д.м.н., зам. гл. врача по медицинской части Городской клинической больницы №67 им. Л.А. Ворохобова123423 Москва, ул. Саляма Адиля, д. 2/44

ДегтяреваЕ. А.DegtyarevaE. A.

д.м.н., проф., гл. врач Детской инфекционной клинической больницы №6, проф. кафедры педиатрии РУДН и РНИМУ 125438 Москва, 3-й Лихачевский пер., д. 2Б

КовалевИ. А.KovalevI. A.

д.м.н., проф., зав. отделением аритмо-логии НИКИ педиатрии 125412 г.Москва, ул.Талдомская, д. 2

СолдатоваИ. Г.SoldatovaI. G.

д.м.н., проф., зам. главного врача по неонатологии Детской городской клинической больницы № 13 им. Н.Ф. Филатова, проф. каф. неонатологии Российского национального исследовательского университета им. Н.Н. Пирогова 123001 Москва, ул. Садовая-Кудринская, д. 15

Городская клиническая больница № 67 им. Л.А. ВорохобоваРоссияLA. Vorokhobov City Clinical Hospital Sixty-Seven, MoscowRussian FederationДетская инфекционная клиническая больница № 6РоссияChildren's Infectious Diseases Clinical Hospital Six, MoscowRussian FederationНаучно-исследовательский клинический институт педиатрииРоссияResearch Clinical Institute of Pediatrics, MoscowRussian FederationДетская городская клиническая больница № 13 им. Н.Ф. Филатова, МоскваРоссияN.F. Filatov City Clinical Hospital Thirteen, MoscowRussian Federation201416032016595101108Copyright © Ltd. “The National Academy of Pediatric Science and Innovation”, 20162016Ltd. “The National Academy of Pediatric Science and Innovation”Ltd. “The National Academy of Pediatric Science and Innovation”https://www.ped-perinatology.ru/jour/about/submissions#copyrightNoticehttps://www.ped-perinatology.ru/jour/article/view/244

Врожденные пороки сердца у детей являются важнейшей проблемой в неонатологии и педиатрии, обеспечивая существенный вклад в структуру неонатальной/младенческой смертности и детской заболеваемости. Независимо от типа порока, само его наличие влияет на гемодинамику и нарушает нормальную жизнедеятельность организма. Дети с гемодинамически значимыми пороками сердца относятся к группе риска тяжелого течения респираторно-синцитиальной (PC) вирусной инфекции. Инфицирование таких пациентов увеличивает продолжительность их пребывания в стационаре, изменяет сроки хирургического вмешательства, осложняет течение послеоперационного периода и повышает риск летального исхода. Возможности лечения инфекции ограничены. Поэтому на первый план выходит ее профилактика, для этой цели используют паливизумаб — единственный в мире препарат для пассивной иммунопрофилактики PC-вирусной инфекции у детей из групп риска ее тяжелого течения. Применение паливизумаба позволяет снизить госпитализированную заболеваемость, продолжительность и тяжесть течения заболевания. Существующие в настоящее время в мире протоколы по профилактике PC-вирусной инфекции у детей из групп риска едины с точки зрения отнесения пациентов с врожденными пороками сердца к категории, нуждающейся в защите. Международный и российский опыт по применению препарата паливизумаб позволил разработать и предложить к использованию представленные в настоящей статье и одобренные на Конгрессе «Детская кардиология 2014» рекомендации по профилактике PC-вирусной инфекции у пациентов с гемодинамически значимыми врожденными пороками сердца.

Congenital heart defects in children are the most important problem in neonatology and pediatrics, by making a significant contribution to the structure of neonatal/infantile mortality and childhood morbidity. Irrespective of the type of a defect, its presence affects hemodynamics and impairs normal vital activity. Children with hemodynamic heart defects belong to a risk group for severe respiratory syncytial (RS) virus infection. Contagion of such patients increases the length of their hospital stay, changes time periods for surgical intervention, complicates a postoperative period, and raises the risk of a fatal outcome. The possibilities of treatment for the infection are limited. Therefore its prevention is put in the forefront; for this purpose, palivizumab, the world's only drug, is used for the passive immunoprevention of RS virus infection in children at risk for its severe form. The drug can reduce in-hospital morbidity and the duration and severity of the disease. The current worldwide protocols for RS virus infection prevention are unified in terms of classifying the patients with congenital heart defects as a category requiring protection. The international and Russian experience with palivizumab could elaborate and propose the guidelines for the prevention of RS viral infection in patients with hemodynamic congenital heart defects, which are given in this paper and have been approved at the congress on Pediatric Cardiology 2014.

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The authors declare that there are no conflicts of interest present.