Invasive mechanical ventilation in the delivery room: is it always worthwhile?

Aleksandrovich, Yu.S.; Пшениснов, К. В.; Chijenas, Vladimiras; Prometnoy, D. V.; Александрович, Иванов Владимир; Pilipene, I.

doi:10.17116/anaesthesiology201805144

Anesteziologiya I Reanimatologiya

2018

DOI: 10.17116/anaesthesiology201805144

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Invasive mechanical ventilation in the delivery room: is it always worthwhile?

Yu.S. Aleksandrovich¹,

К. В. Пшениснов²,

Vladimiras Chijenas³

et al.

Abstract: Оптимизация респираторной поддержки сразу после рождения ребенка является одной из сложных задач современной неонатологии и интенсивной терапии новорожденных. Цель исследования-оптимизация респираторной поддержки у недоношенных новорожденных в родильном зале путем изучения прогностической значимости особенностей течения беременности, родов, клинико-лабораторного статуса и выявления факторов риска инициации инвазивной искусственной вентиляции легких (ИВЛ). Материал и методы. Обследованы 99 новорожденных. Средня… Show more

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“…INTRODUCTION. Particular attention is paid to the study of the health of premature newborns with birth body weight less than 1000 g. Current scientific advances in the field of perinatal technology have significantly improved the survival rate of newborns with an extremely low birth weight [1,2]. The birth rate of babies with a low birth weight (less than 1000 g) is 0.2 %, with an extremely low birth weight (from 1000 to 1500 g) it is equal to 0.8 % [3].…”

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Thiamine Deficiency in Extremely Premature Newborns

Ushakovа

Brazaluk

Yevstafieva

2019

MCCh

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Introduction. The critical state of extremely premature newborns is accompanied by significant oxidative stress, which leads to an increase in anaerobic metabolism; impaired oxygen utilization in mitochondrial oxidation may occur due to thiamine deficiency. The aim of the study – to learn the thiamine status of extremely premature new-borns in the neonatal period follow-up. Research Methods. The study involved 55 of premature newborns with birth weight less than 1000 g and 35 healthy full-term newborns. The indicated children’s blood tests were made in the first day of life and at the end of the neonatal period. The lactate and magnesium were determined by colorimetric method; the pyruvate content was determined enzymatically; the concentration of vitamin B1 was studied using a fluorimeter. Results and Discussion. In the first days of life, all premature infants have a significantly lower level of thiamine in the blood than the normal one, with the low limit of the norm of mature infants, due to the greatest intensity of adaptive reactions and the redistribution of nutrients in fasting. The deficiency of thiamine of extremely premature infants is accompanied by hypomagnesemia. The defining factor of thiamine deficiency of premature infants is morphofunctional immaturity. Deficiency of thiamine of premature infants is correlated with hyperlactatemia throughout the neonatal period. The metabolic features of an organism of a newborn with an extremely low birth weight reflect hypoxic disturbances (increased lactate and pyruvate level, changes in their ratio), which indicates the activation of glycolysis. The highest level of pyruvate was observed in premature infants in the first day of life and significantly exceeded the reference values with subsequent decrease during the first month of life, but remained beyond the norm, resulting in the development of secondary acidosis and persistent decrease in aerobic metabolism. Thiamine deficiency contributes to the pathogenesis of suppression of the pyruvate-dehydrogenase complex, bypassing pyruvate towards lactate overproduction and the development of metabolic acidosis. Conclusion. Deficiency of thiamine in premature newborns may lead to a deeper critical condition.

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Thiamine Deficiency in Extremely Premature Newborns

Ushakovа

Brazaluk

Yevstafieva

2019

MCCh

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Non-invasive respiratory support in premature infants in the delivery room

Linkhoeva¹,

Aleksandrovich²,

Пшениснов³

et al. 2020

Anesteziologiya I Reanimatologiya

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Endobronchial surfactant administration in full-term newborn with respiratory distress syndrome

Ivanov

Kiriakov²,

Пшениснов³

et al. 2023

Pediatr (SPb)

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Neonatal respiratory distress syndrome is the leading cause of neonatal acute respiratory failure. Despite the successes achieved and the existing international recommendations, in some cases there is a severe course of this disease, which requires a personalized approach to the patient and intensive care measures. The article presents a case of successful treatment of acute respiratory distress syndrome in a full-term newborn complicated by pulmonary barotrauma using monobronchial administration of exogenous surfactant under X-ray control. In order to assess the course of the disease and the effectiveness of treatment, a retrospective analysis of medical documentation was carried out. From the first minutes of life, the child had respiratory disorders, which was the basis for non-invasive mechanical lung ventilation nCPAP (nasal continuous positive airway pressure). Progression of hypercapnia and hypoxemia was revealed over time, and therefore tracheal intubation was performed and convective mechanical ventilation was started with FiO2 = 1,0. Monobronchial administration of exogenous surfactant was a key element of the therapy that allowed to achieve stabilization of the condition and regression of gas exchange disorders with complete recovery of the patient. Monobronchial administration of surfactant in acute respiratory distress syndrome with heterogeneous lung involvement is an effective treatment option and can be used in clinical practice for refractory hypoxemia.

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Invasive mechanical ventilation in the delivery room: is it always worthwhile?

Cited by 3 publications

References 12 publications

Thiamine Deficiency in Extremely Premature Newborns

Thiamine Deficiency in Extremely Premature Newborns

Non-invasive respiratory support in premature infants in the delivery room

Endobronchial surfactant administration in full-term newborn with respiratory distress syndrome

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