[Severity of the lung disease index in infants with respiratory distress syndrome].

UNLABELLED: Optimization of respiratory support and prevention of ventilator-associate lung injure are the most important problems of neonatal resuscitation and intensive care. THE AIM OF THE STUDY: To improve the results of intensive care for respiratory failure in preterm infants by optimizing respiratory support on the basis of the analysis of the biomechanical characteristics of the lungs and blood gas. MATERIALS AND METHODS: The study included 138 infants with birth weight 1500g (1300-1740g) and a gestational age of 30.5 (29-32) weeks in need of mechanical ventilation. Apgar score at one minute was equal to 5.0 (4.0-6.0) points, and the fifth--7.0 (6.0-7.0) points. Biomechanical properties of light investigated the dynamic lung compliance, aerodynamic upper airway resistance, the coefficient of hyperextension, the time constant and the coefficient of RVR, reflecting the patient's spontaneous breathing pattern were evaluated. RESULTS: It was found that the most significant biomechanical characteristics of lungs, reflecting the severity of the respiratory failure are the dynamic compliance, aerodynamic airway resistance, coefficient C20/C, and the time constant. Correlation between the index of oxygenation, clinical assessment of the severity of respiratory failure and the duration of control mechanical ventilation was demonstrated. CONCLUSION: Rate of hyperextension and time constant are expressed by the correlation with the level of the oxygenation index, which allows them to be used for screening evaluation of severity critically ill patients during admission to the neonatal intensive care unit.

[Role of intensive care consulting centers in reducing infantile mortality].

The paper describes the major tasks, functions, and structure of intensive care consulting centers (ICCC), gives the variables characterizing the activities of ICCC, analyzes their impact on infantile mortality rates in a large region, by using the Leningrad Region as an example, and shows it necessary to set up an ICCC in all regions of the Russian Federation.

[Multiple organ dysfunction syndrome in newborn infants].

The present paper outlines the basic idea on multiple organ dysfunctions in the newborn. The major clinical manifestations of multiple organ dysfunctions (MOD) have been studied and are described. The basic systems most susceptible to MOD are determined, and the critical stages of neonality when the development of MOD is extremely high are identified.

[Evaluation of activities of pediatric departments of resuscitation and intensive care]. / Otsenka deiatel'nosti pediatricheskikh otdelenii reanimatsii i intensivenoi terapii.

A new system of quality parameters has been developed, that may be used to assess the efficacy of intensive care units (ICU). This approach is based on regular assessment of the severity of the patient's condition and the adequacy of the treatment modalities administered to the patient. The suggested approach to evaluation of ICU activity helps analyze the activities of different hospitals, the efficacies of new treatment modalities and the treatment policy chosen.