Analysis of the respiratory therapy in newborns with extremely low body weight at birth

Respiratory therapy is the main component of intensive care for premature newborns, it has a great influence on nursing outcomes.

Characteristics of children and research methods. The authors carried put a retrospective analysis of the intensive care effectiveness in 44 infants with extremely low body mass at birth.

Results. They found the cases of bronchopulmonary dysplasia and evaluated the treatment effectiveness depending on the weight and gestational age. The children with birth weight of 500–699 grams demonstrated low efficiency of intensive care and adverse course of bronchopulmonary dysplasia. This group of premature infants was characterized by a prolonged stay in the intensive care unit, mechanical ventilation, low body mass dynamics, and, as a result, had a high mortality rate in the late neonatal period compared to the group of children born with a birth weight of more than 700 g (p <0.05).

Conclusion. Effective nursing of preterm infants with a birth weight less than 700g requires a combination of an individual approach to the auxiliary ventilation methods and a non-invasive ventilation regimen along with pharmacotherapy that stimulates the respiratory center of the newborn and promotes the maturation of surfactant to prevent complications of respiratory therapy.

1. Демьянова Т.Г., Григорьянц Л.Я., Авдеева Т.Г., Румянцев А.Г. Наблюдение за глубоко недоношенными детьми на первом году жизни. М.: МЕДПРАКТИКА, 2006; 148. [Demjanova T.G., Grigoriants L.Ya., Avdeeva T.G., Rumyantsev A.G. Observation of deeply premature babies in the first year of life. Moscow: MEDPRAKTIKA, 2006; 148 (in Russ.)]

2. Subramanian S., Rosencrantz T. Extremely Low Birth Weight Infant. 2011. URL: http://emedicine.medscape.com/article/979717-overview#showall (дата доступа: 15.12.2012).

3. Larroque B., Ancel P-Y., Marret S., Marchand L., Andre M., Arnaud C. et al. Neurodevelopmental disabilities and special care of 5-year-old children born before 33 weeks of gestation (the EPIPAGE study): a longitudinal cohort study. Lancet 2008; 371: 813–820. DOI: 10.1016/S0140-6736(08)60380-3

4. Stoll B.J., Hansen N.I., Bell E.F., Shankaran S., Laptook A.R., Walsh M.C. et al. Neonatal Outcomes of Extremely Preterm Infants from the NICHD Neonatal Research Network. Pediatrics 2010; 126(3): 443–456. DOI: 10.1542/peds.2009-2959

5. Tyson J. E. Parikh N.A., Langer J., Green C., Higgings R.D. Intensive care for extreme prematurity – moving beyond gestational age. N Engl J Med 2008; 358(16):1672–1681. DOI: 10.1056/NEJMoa073059

6. Перепелица С.А., Голубев А.М., Мороз В.В. Расстройства микроциркуляции при респираторном дистресс синдроме новорожденного (морфологическое исследование). Общая реаниматология 2016; 12(6): 16–26. [Perepelitsa S.A., Golubev A.M., Moroz V.V. Microcirculation disorders in respiratory distress of a newborn ( morphologicalstudy). Obshhaya reanimatologiya ( General Reanimatology) 2016; 12(6):16–26 (in Russ.)]

7. Kusuda S., Fujimura M., Sakuma I., Aotani H., Kabe K., Itani Y. et al. Morbidity and Mortality of Infants with Very Low Birth Weight in Japan: Center Variation. Pediatrics 2006; 18: 1130–1138. DOI: 10.1542/peds.2005-2724

8. Meadow W., Lantos J. Moral Reflections on Neonatal Intensive care. Pediatrics 2009; 123(2): 595–597. DOI: 10.1542/peds.2008-1648

9. Zeitlin J., Ancel P.-I. Interpreting data on the health outcomes of extremely preterm babies. Arch Dis Child Fetal Neonatal Ed 2011; 96(5): F314–6. DOI: 10.1136/adc.2010.202168

10. Володин Н.Н. Ведение новорожденных с респираторным дистресс-синдромом. Клинические рекомендации. М., 2016; 48. [Volodin N.N. Management of newborns with respiratory distress syndrome. Clinical recommendations. Moscow, 2016; 48 (in Russ.)]

11. Миткинов О.Э., Горбачев В.И. Влияние стратегии респираторной поддержки новорожденных в отделение интенсивной терапии. Анестезиология и реаниматология 2015; 60(2): 39–43. [Mitkinov O.E., Gorbachev V.I. Influence of strategy of respiratory support of newborns in intensive care unit. Аnesteziologiya i reanimatologiya (Anesthesiology and Reanimatology) 2015; 60(2): 39–43 (in Russ.)]

12. Hu Q., Lian J.M., Li J.Q. Efficacy of intravenous or atomizing ambroxol for prevention of respiratory distress syndrome in preterm infants. Zhongguo Dang Dai Er Ke Za Zhi 2006; 8(4): 301–303.

13. Суворов С.Г., Лекманов А.У., Ярошецкий А.И., Проценко Д.Н., Гельфанд Б.Р. Национальное эпидемиологическое исследование «РуВент»: применение искусственной вентиляции легких в отделениях реанимации и интенсивной терапии у детей. Анестезиология и реаниматология 2015; 60(2): 27–32. [Suvorov S.G., Lekmanov A.U., Jaroshetsky A.I., Protsenko D.N., Gelfand B.R. National epidemiological study « RuVent»: use of artificial ventilation in the intensive care units in intensive care in children. Аnesteziologiya i reanimatologiya (Anesthesiology and Reanimatology) 2015; 60(2): 27–32 (in Russ.)]

14. Миронов П.И. Диагностика профилактика и лечение вентилятор- ассоциированной пневмонии у новорожденных. Вестник интенсивной терапии 2014; 4: 15– 24. [Mironov P.I. Diagnostics of prevention and treatment of ventilator-associated pneumonia in neonates. Vestnik intensivnoi terapii 2014; 4: 15–24 (in Russ.)]

15. Tuten A., Dincer E., Topcuoglu S., Sancak S., Akar S., Toptan H.H. et al. Serum lactate levels and perfusion index: are these prognostic factors on mortality and morbidity in very low-birth weight infants? J Matern Fetal Neonatal Med 2016; 30(9): 1092–1095. DOI: 10.1080/14767058.2016.1205019