OPEN DUCTUS ARTERIOSUS IN PREMATURE INFANTS WITH EXTREMELY LOW AND VERY LOW BODY WEIGHT
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Abstract
The aim of the research – to identify significant factors affecting the postnatal functioning of PDA in premature infants with extremely low and very low body weight and to evaluate them from a manageability perspective.
Materials and methods. In a continuous prospective study, 98 premature infants in the first 72 hours of life were divided into 2 groups according to the results of an echocardiological examination (67 children with PDA, 31 children without DA At the age of 1 month of life, 90 newborns were monitored, 48 children had open AP, and 42 children had no AP. Hemodynamic and laboratory data (NT- proBNP) were studied.
Results. At 72 hours of life, premature infants with PDA and without it had no hemodynamic differences. At 1 month of life, the features of intracardiac hemodynamics were revealed in the PDA group: myocardial hypertrophy (thickness interventricular septum 3.26 mm, p = 0.039), dilation of the left ventricle (end systolic volume 1.97 ml, p = 0.04), tricuspid regurgitation (21.29 mmHg, p = 0.021). The level of NT – proBNP in the early neonatal period and at 1 month of life did not exceed the accepted reference values. At 1 month, a significant set of factors was determined: the duration of the anhydrous period, the Apgar score at 5 minutes, the syndrome of general depression of the central nervous system at 2 weeks of life, respiratory acidosis at birth, hemodynamic parameters at 72 hours of life (large final diastolic size and open oval window), changes in the pulmonary interstitium at 2 weeks of life, based on which, using multiple logistic regression, an algorithm for the probability of PDA is constructed. Controlled and controllable factors of the state of the AP can be recognized as the parameters of the acid-base state.
Conclusion. Signs of myocardial remodeling were diagnosed as a result of adaptive processes in the body of premature infants. Assessment and correction of the acid-base state parameters (BE, pO2 and pCO2) in the first 72 hours of postnatal life will allow monitoring of PDA.
Keywords
Author Biographies
Людмила Николаевна Игишева,
Igisheva Ljudmila Nikolaevna
MD, PhD, professor, department of pediatrics and neonatology.
The main specialist in cardiology in the city.
She does a research on problems of heart rate variability in healthy children and children in various diseases, the comprehensive assessment of health status and rehabilitation of school-aged children.
In 1996 she defended her Candidate dissertation, in 2006 – her Doctoral Thesis “A Systematic Approach to the Assessment of Health Status and Rehabilitation of Children in Terms of Learning Activity”.
The priority: cardiology.
He has taught 3 Candidates of Medical Sciences, and 5 Candidate dissertations are currently are being scheduled. She has 187 works published. According to the RSCI the common number of quotations is 579, a personal h–index is 10. She is a member of the Dissertation Council D 212.088.09 of Kemerovo State University.
She has the diploma of Laureate of the “Innovation and Invention of the Year” competition for the invention of “Scoring System of the Human Body State «ORTHO»”. In 2001 she became the winner of regional competition of methodological developments, she was awarded for her studying manual “Health Promotion in the Terms of Boarding-School”. The research results made by L. N. Igisheva were put into practice of the Cardiology Department of Kemerovo, wellness centre for children and adolescents and educational organizations of Kuzbass and Russia.Жанна Анатольевна Звягина,
neonatologist, department of neonatal pathologyЕлена Глебовна Цой,
candidate of medical sciences, docent, docent of the department of pediatrics and neonatologyАндрей Владимирович Шабалдин,
doctor of medical sciences, docent, professor of the department of polyclinic pediatrics, propaedeutics of childhood diseases and postgraduate trainingТамара Михайловна Вакулова,
assistante of the department of polyclinic pediatrics, propaedeutics of childhood diseases and postgraduate trainingArticle Details
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The authors declare that they have no apparent or potential conflicts of interest related to the publication of this article.
This work is licensed under a Creative Commons Attribution 4.0 License.
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