This article presents a clinical case of the successful surgical treatment of a newborn with intrapericardial teratoma, which was initially diagnosed in the postnatal period, complicated by multiple organ failure, including severe cardio-respiratory disorders and acute renal damage. The systematized results of clinical, electrophysiological, radiation, and morphological diagnostics during the initial examination and at the stages of supervision of the newborn are reported. On the nineteenth day of life, significant multidisciplinary cooperation was implemented to perform a radical surgical intervention to remove the intrapericardial teratoma in a patient in critical condition due to heart compression and intrathoracic tension syndrome, which determined the needed prosthetics for vital functions. Two months after the operation, the efficiency of the intervention and complex therapy was confirmed by the direct results and data of the infants examination. The organizational aspects provided newborns with emergency multidisciplinary specialized medical care.
The purpose of the study was to compare the values of acid base balance, electrolytic and hemodynamic parameters in newborns depending on the composition of intraoperative infusion therapy. The study was done in 60 newborns who were given Staerofundin ISO basic infusion (10 ml/kg/hour) in group I (n=31) and normal saline solution in group II (n=29) during a surgery.Results: following the surgery, no differences in pH values were observed between the groups, moderate metabolic disturbances were found. In Group II, levels of bicarbonates decreased from 22.2 to 20.5 (р=0.047). By the end of the surgery, normal electrolyte composition was found more frequently in group I (29%) as compared to group II (20%). Hypopotassemia (34.5% and 22.6%), hyperpotassemia (44.8% and 25.8%) and hyperchloremia (63% and 51.7%) were found more frequently in group II as compared to group I, respectively. To achieve the target level of blood pressure, the bolus was injected to 29% (n=9) of children from group I and 17.2% (n=5) of children from group II. Adrenergic agonists were used in 42% of children from group I and 27.6% of children from group II (р=0,038). There were no differences between the cumulative doses.Conclusion. Sterofundin and normal saline solution demonstrated equivalent values of effectiveness and produced similar effect on the values of acid base balance, electrolytic and hemodynamic parameters during the intraoperative period in newborns.
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