The possibility of reducing mortality in the neonatal intensive care unit

Dar’ja V Asherova-Jushkova; Ашерова-Юшкова Дарья Владимировна; Marina A Kovaljova; Ковалёва Марина Александровна; Tatjana V Chaparova; Чапарова Татьяна Владимировна; Anna A Shmeljova; Шмелёва Анна Александровна; Elena V Gorodova; Городова Елена Викторовна; Anatolii Yu Ljasthenko; Лященко Анатолий Юрьевич; Yulia S Badanina; Баданина Юлия Сергеевна; Marina O Protasova; Протасова Марина Олеговна; Anna A Pelevina; Пелевина Анна Алексеевна; Sergei N Kocheshkov; Кочешков Сергей Николаевич

doi:10.17816/PED7240-46

The possibility of reducing mortality in the neonatal intensive care unit

作者: Asherova-Jushkova D.V¹, Kovaljova M.A¹, Chaparova T.V², Shmeljova A.A², Gorodova E.V², Ljasthenko A.Y.², Badanina Y.S², Protasova M.O², Pelevina A.A², Kocheshkov S.N²
隶属关系:
1. State Budgetary Institution of Healthcare of Yaroslavl Region “Regional Perinatal Center”
2. St Petersburg State Pediatric Medical University of Ministry of Health of the Russian Federation
期: 卷 7, 编号 2 (2016)
页面: 40-46
栏目: Articles
URL: https://journals.eco-vector.com/pediatr/article/view/3620
DOI: https://doi.org/10.17816/PED7240-46
ID: 3620

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The analysis of outcomes of various conditions of the premature neonates with extremely low (ELBW) and the very low body weight (VLBW), who were hospitalized for the last 3 years in the neonate intensive care unit (NICU) of the Yaroslavl regional perinatal center was carried out. Comparison of a lethality of premature with ELBW and VLBW depending on change of approaches to respiratory support, both in the delivery room, and at further stages of treatment, antibacterial strategy and infectious control in the department was performed. Was shown 2,5 fold decrease of mortality due to less invasive surfactant administration (LISA) in a combination with strategy of “the prolonged inspiration” and “open lungs”, the reduction of indications to mechanical ventilation. In study group, with use of LISA technique demonstrated the best survival (16,1 vs 53,0 %, р < 0,0002), smaller need for mechanical ventilation (38,7 vs 86,4 % р < 0,0037), reliable reduction of severe intraventricular hemorrhage (IVH) frequency: IVH3 - 12,9 vs 45,5 % (р < 0013), IVH4 - 6,5 vs 33,3 %(p < 0,0028). In the study group bronchopulmonary dysplasia rate was lower, but retinopathy of prematurity developed more often. The role of microbiological monitoring in NICU, restriction of antibiotic administration indications for reduction of intrahospital infection risks of was shown. Introduction of strict measures of infectious control allowed to reduce incidence of a necrotizing enterocolitis (NEK) from 1,5 to 0,4 % and the related mortality.

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premature neonates, mortality

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Ионов О.В., Рындин А.Ю., Антонов А.Г., и др. Сурфактантная терапия в комплексном лечении респираторной патологии у глубоко недоношенных детей // Российский вестник акушера-гинеколога. - 2013. - № 3. - С. 108-114. [Ionov OV, Ryndin AY, Antonov AG, et al. Surfactant therapy in complex treatment of respiratory disease in extremely premature infants. Rossiyskiy vestnik akushera-ginekologa. 2013;3:108-114. (In Russ).]
Göpel W, Kribs A, et al. (German Neonatal Network) Less invasive surfactant administration is associated with improved pulmonary outcomes in spontaneously breathing preterm infants. Acta Paediatr. 2015; 104(3):241-6. doi: 10.1111/apa.12883.
Klebermass-Schrehof K, Wald M, Schwindt J, et al. Less Invasive Surfactant Administration in Extremely Preterm Infants: Impact on Mortality and Morbidity. Neonatology. 2013;103:252ß258.
Lin PW, Stoll BJ. Necrotising enterocolitis. Lancet. 2006; Oct 7;368(9543):1271ß83.
Stevens TP, Blennow M, Meyers EH, Soll RF. Early surfactant administration with brief ventilation vs. selective surfactant and continued mechanical ventilation for preterm infants with or at risk for respiratory distress syndrome. Cochrane Database Syst Rev. 2007;4:CD00306. doi: 10.1002/14651858.cd003063.pub3.

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The possibility of reducing mortality in the neonatal intensive care unit

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详细

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作者简介

Dar’ja Asherova-Jushkova

Marina Kovaljova

Tatjana Chaparova

Anna Shmeljova

Elena Gorodova

Anatolii Ljasthenko

Yulia Badanina

Marina Protasova

Anna Pelevina

Sergei Kocheshkov

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