IMPACT OF INTERCURRENT DISEASES ON THE BIOMECHANICAL FUNCTION OF THE LUNG IN NEWBORNS WITH SEVERE ASPHYXIA DURING SYSTEMIC THERAPEUTIC HYPOTHERMIA


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Objective. To determine the impact of intercurrent conditions on the biomechanical function of the lung in newborns with prior severe birth asphyxia during systemic therapeutic hypothermia. Subjects and methods. The study included 40 newborns with severe birth asphyxia. According to the type of an intercurrent disease, all the babies were divided into 4 groups. Results. Meconium aspiration syndrome (MAS) and intrauterine infection (IUI) significantly increase the length of hospital stay in the intensive care units and prolonged mechanical ventilation (MV). At the beginning of hypothermia, inspired oxygen fraction (FiO2), mean airway pressure (MAP), and respiratory rate (RR) decreased and reached minimum by the end of day 3 in infants without intercurrent diseases. At 12 hours of life, the newborn infants with MAS and IUI were observed to have increases in all MV parameters, as in these groups, there was a transition to high-frequency MV and an association with persistent pulmonary hypertension. Conclusion. While assessing compliance, FiO2, MAP, and oxygenation index, one may estimate the severity of a respiratory system lesion and predict the duration of MV. The infants with MAS and IUI have a more severe respiratory system lesion, which require more careful monitoring of acid-base balance and MV parameters. There were no fatal outcomes in all the examined groups.

Full Text

Restricted Access

About the authors

Aleksandr Anatol'evich Zarubin

Email: aleksandr-zarubin@mail.ru
Graduate student, assistant of the Department of Anesthesiology and Intensive Care, Irkutsk State Medical University, Ministry of Health of Russia; Doctor, Irkutsk City Perinatal Center. 664003, Russia, Irkutsk, Krasnogo Vosstaniya str. 1

Igor Professor Golub

Doctor of Medical Sciences, Head of the Department of anesthesiology and Intensive Care, Irkutsk State Medical University. 664003, Russia, Irkutsk, Krasnogo Vosstaniya str. 1

N. I Micheeva

Doctor, Irkutsk City Perinatal Center. 664025, Russia, Irkutsk, Surikova str. 16

Arina D Bogdanova

Doctor, Irkutsk City Perinatal Center. 664025, Russia, Irkutsk, Surikova str. 16

Olga S Fedorova

Doctor, Irkutsk City Perinatal Center. 664025, Russia, Irkutsk, Surikova str. 16

References

  1. Kurinczuk J.J., White-Koning M., Badawi N. Epidemiology of neonatal encephalopathy and hypoxic-ischaemic encephalopathy. Early Hum. Dev. 2010; 86(6): 329-38.
  2. Gluckman P.D., Williams C.E. When and why do brain cells die? Dev. Med. Child Neurol. 1992; 34(11): 1010-4.
  3. De Menezes M.S. Hypoxic-ischemic brain injury in the newborn. 2013. Available at: http:// emedicine.medscape.com/article/1183351
  4. Platt M.J., Cans C., Johnson A., Surman G., Topp M. et al. Trends in cerebral palsy among infants of very low birthweight (<1500 g) or born prematurely (<32 weeks) in 16 European centres: a database study. Lancet. 2007; 369(9555): 43-50.
  5. TOBY Protocol and handbook. Available at: https://www.npeu.ox.ac.uk/ tobyregister/docs Accessed 25.11.2015.
  6. Колганова А.А. Прогнозирование мекониальной аспирации у плода в анте- и интранатальном периодах: дисс.. канд. мед. наук. Ростов н/Д.; 2010. 160с. [Kolganova A.A. Prediction of meconium aspiration in the fetus in the ante- and intrapartum periods. Diss. Rostov-on-Don; 2010. 160p. (in Russian)]
  7. Буштырева И.О., Чернавский В.В., Колганова А.А. Синдром аспирации мекония. Саратовский научно-медицинский журнал. 2010; 6(2): 378-83. [Bushtyreva I.O. Chernavskii V.V., Kolganova A.A. Meconium aspiration syndrome. Saratovskiy nauchno-meditsinskiy zhurnal. 2010; 6(2): 378-83. (in Russian)]
  8. El Shahed A.I., Dargaville P., Ohlsson A., Soll R.F. Surfactant for meconium aspiration syndrome in full term/near term infants. Cochrane Database Syst. Rev. 2007; (3): CD002054.
  9. Zhang D.S., Chen C., Zhou W., Chen J., Mu D.Z. Pathogens and risk factors for ventilator-associated pneumonia in neonates. Zhongguo Dang Dai Er Ke Za Zhi. 2013; 15(1): 8-14.
  10. Сурков Д.Н., Капустина О.Г., Иванов Д.О. Влияние искусственной вентиляции легких на церебральный статус у новорожденных в остром периоде гипоксически-ишемической энцефалопатии. Вестник современной клинической медицины. 2014; 7(6): 46-55. Available at: http://cyberleninka. ru/article/n/vliyanie-iskusstvennoy-ventilyatsii-legkih-na-tserebralnyy-status-u-novorozhdennyh-v-ostrom-periode-gipoksicheski-ishemicheskoy Accessed 11.02.2016. [Surkov D.N., Kapustina O.G., Ivanov D.O. Effect of mechanical ventilation on cerebral status in newborns with acute hypoxic-ischemic encephalopathy. Vestnik sovremennoy klinicheskoy meditsinyi. 2014; 7(6): 46-55. Available at: http://cyberleninka.ru/article/n/vliyanie-iskusstvennoy-ventilyatsii-legkih-na-tserebralnyy-status-u-novorozhdennyh-v-ostrom-periode-gipoksicheski-ishemicheskoy Accessed 11.02.2016. (in Russian)]
  11. Abbasi S., Sivieri E., Roberts R., Kirpalani H. Accuracy of tidal volume, compliance, and resistance measurements on neonatal ventilator displays: an in vitro assessment. Pediatr. Crit. Care Med. 2012; 13(4): 262-8.
  12. Овсянников Д.Ю., Бойцова Е.В., Беляшова М.А., Ашерова И.К. Интерстициальные заболевания легких у младенцев. М.: РУДН; 2014. 182с. [Ovsyannikov D.Yu., Boytsova E.V., Belyashova M.A., Asherova I.K. Interstitial lung disease in infants. Moscow: PFUR; 2014. 182p. (in Russian)]
  13. Clark D.A., Nieman G.F, Thompson J.E., Paskanik A.M., Rokhar J.E., Bredenberg C.E. Surfactant displacement by meconium free fatty acids: an alternative explanation for atelectasis in meconium aspiration syndrome. J. Pediatr. 1987; 110(5): 765-70.
  14. Gautam A., Ganu S.S., Tegg O.J., Andresen D.N., Wilkins B.H., Schell D.N. Ventilator-associated pneumonia in a tertiary paediatric intensive care unit: a 1-year prospective observational study. Crit. Care Resusc. 2012; 14(4): 283-9.
  15. Hill A., Volpe J.J. Neurologic disorders. In: Avery G.B., Fletcher M.A., MacDonald M.G., eds. Neonatology: pathophysiology and management of the newborn. Philadelphia: Lippincott-Raven Publ.; 1994: 1117-38.
  16. Антонов А.Г. Методика проведения лечебной гипотермии детям, родившимся в состоянии асфиксии. Анестезиология и реаниматология. 2014; 6: 76-8. [Antonov A.G. The methodology of therapeutic hypothermia to children born in a state of asphyxia. Anesteziologiya i reanimatologiya. 2014; 6: 76-8. (in Russian)]
  17. American Academy of Pediatrics, American Heart Association. Textbook of neonatal resuscitation. 6th ed. American Heart Association; 2010.
  18. Александрович Ю.С., Блинов С.А., Пшениснов К.В., Паршин Е.В. Критерии тяжести поражения легких у новорожденных с респираторным дистресс-синдромом. Анестезиология и реаниматология. 2014; 1: 52-7. Available at: http://cyberleninka.ru/article/n/kriterii-tyazhesti-porazheniya-legkih-u-novorozhdennyh-s-respiratornym-distress-sindromom. Accessed 11.02.2016. [Aleksandrovich Yu.S., Blinov S.A., Pshenisnov K.V., Parshin E.V. Criteria for severity of lung damage in neonates with respiratory distress syndrome. Anesteziologiya i reanimatologiya. 2014; 1: 52-7. Available at: http://cyberleninka. ru/article/n/kriterii-tyazhesti-porazheniya-legkih-u-novorozhdennyh-s-respiratornym-distress-sindromom. Accessed 11.02.2016. (in Russian)]
  19. Wiswell T.E., Tuggle J.M., Turner B.S. Meconium aspiration syndrome: have we made a difference? Pediatrics. 1990; 85(5): 715-21.
  20. Cleary G.M., Wiswell T.E. Meconium-stained amniotic fluid and the meconium aspiration syndrome. An update. Pediatr. Clin. North Am. 1998; 45(3): 511-29.
  21. Зарубин А.А., Голуб И.Е., Богданова А.Д., Мельников В.А., Ионушене С.В., Федорова О.С. Применение лечебной гипотермии при лечении тяжелой интранатальной асфиксии. Universum: Медицина и фармакология. Электронный научный журнал. 2015; 11(22). Available at: http://7universum. com/ru/med/archive/item/2714 Accessed 10.01.2016. [Zarubin A.A., Golub I.E., Bogdanova A.D., Melnikov V.A., Ionushene S.V., Fedorova O.S. The use of therapeutic hypothermia in the treatment of severe intrapartum asphyxia. Universum: Medicine and Pharmacology. Electronic scientific journal. 2015; 11(22). Available at: http://7universum.com/ru/med/archive/item/2714 Accessed 10.01.2016. (in Russian)]
  22. Бубнова Н.И., Тютюнник В.Л., Михайлова О.И. Репродуктивные потери при декомпенсированной форме плацентарной недостаточности, вызванной инфекцией. Акушерство и гинекология. 2010; 4: 55-8. [Bubnova N.I., Tyutyunnik V.L., Mikhaylova O.I. Reproductive losses in decompensated placental insufficiency caused by infection. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2010; 4: 55-8. (in Russian)]
  23. Шабалов Н.П. Неонатология. Учебное пособие. т.1. М.: МЕДпресс-информ; 2004. 608с. [Shabalov N.P. Neonatology. Tutorial. Vol. 1. Moscow: MEDpress-inform; 2004. 608p. (in Russian)]
  24. Холичев Д.А., Стецкая Ю.Н., Сенькевич О.А. Искусственная вентиляция легких у детей с перинатально обусловленным аспирационным синдромом. Дальневосточный медицинский журнал. 2015; 2: 41-4. Available at: http://cyberleninka.ru/article/n/iskusstvennaya-ventilyatsiya-legkih-u-detey-s-perinatalno-obuslovlennym-aspiratsionnym-sindromom Accessed 11.02.2016. [Holichev D.A., Stetskaya Yu.N., Senkevich O.A. Mechanical ventilation in children with perinatal aspiration syndrome caused. Dalnevostochnyiy meditsinskiy zhurnal. 2015; 2: 41-4. Available at: http://cyberleninka.ru/article/n/ iskusstvennaya-ventilyatsiya-legkih-u-detey-s-perinatalno-obuslovlennym-aspiratsionnym-sindromom Accessed 11.02.2016. (in Russian)]
  25. Дассиос Т., Остин Т. Показатели функции внешнего дыхания у новорожденных, находящихся на искусственной вентиляции легких при проведении системной лечебной гипотермии. Неонатология: новости, мнения, обучение. 2014; 1: 65-70. [Dassios T., Ostin T. Indicators of respiratory function in neonates receiving mechanical ventilation system during therapeutic hypothermia. Neonatologiya: novosti, mneniya, obuchenie. 2014; 1: 65-70. (in Russian)]
  26. Lin H.C., Su B.H., Lin T.W., Peng C.T., Tsai C.H. Risk factors of mortality in meconium aspiration syndrome: review of 314 cases. Acta Paediatr. Taiwan. 2004; 45(1): 30-4.
  27. Бондарев В.В., Горелик К.Д. Мекониальная аспирация, этиология, патоморфологические механизмы, оказание помощи на догоспитальном этапе. В кн.: Конференция, посвященная памяти профессора Э.К. Цыбулькина: Материалы. М.; 2004: 28-32. [Bondarev V.V., Gorelik K.D. Meconium aspiration, etiology, pathological mechanisms to assist in the pre-hospital stage. In: The conference, dedicated to the memory of Professor E.K. Tsybulkin: Materials. Moscow; 2004: 28-32. (in Russian)]
  28. Armstrong L., Stenson B.J. Use of umbilical cord blood gas analysis in the assessment of the newborn. Arch. Dis. Child. 2007; 92(6): F430-4.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies