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Актуальность дополнительной профессиональной образовательной программы повышения квалификации вра... more Актуальность дополнительной профессиональной образовательной программы повышения квалификации врачей по теме «Интенсивная терапия острой дыхательной недостаточности в условиях коронавирусной пандемии» обусловлена необходимостью обучения специалистов здравоохранения навыкам своевременного выявления, диагностики и оказания медицинской помощи пациентам, инфицированным COVID-19
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care
BACKGROUND: The medical evacuation of premature newborns to institutions providing a higher level... more BACKGROUND: The medical evacuation of premature newborns to institutions providing a higher level of medical care results in the reduction of death risk. The use of pediatric intensive care units in level 2 organizations for the hospitalization of newborns can be a potential solution to the lack of neonatal beds in level 3 institutions. AIM: This study aimed to determine the predictors of the re-evacuation of newborns from level 2 medical organizations to level 3 institutions. MATERIALS AND METHODS: This observational, cohort, retrospective study included data of 284 cases of the evacuation of newborns from level 1 and 2 medical organizations without a pediatric intensive care unit to level 2 medical organizations with a pediatric intensive care unit. The sample was divided into two groups: the first group included patients who received the necessary therapy in level 2 medical organizations and did not require further evacuation to level 3 (n = 261), and the second group included pa...
Annals of Critical Care
INTRODUCTION: Assessment of the patient’s condition and prediction of outcomes is critically impo... more INTRODUCTION: Assessment of the patient’s condition and prediction of outcomes is critically important during pre-transport stabilization and remains the most complex challenges of the activities of transport teams. A significant variety of scales and different requirements for their application indicates that there is no consensus on the choice of a specific scale and predictive tool. OBJECTIVE: To study hospital outcomes in transported newborns, depending on the assessment on the TRIPS scale (Transport Risk Index of Physiological Stability for Newborn Infants). MATERIALS AND METHODS: The оbservational, cohort, retrospective study included data from 604 trips of the transport team to newborns consulted by resuscitation and consultative center from August 1, 2017 to December 31, 2018. The total sample was divided into groups depending on the assessment of the score, followed by a comparison of characteristics and outcomes in these groups. RESULTS: There is a significant difference i...
Annals of Critical Care
Introduction. Standardized assessment of the patient status and the decision on the possibility o... more Introduction. Standardized assessment of the patient status and the decision on the possibility of transfer is an essential part of the neonatal transport service. However, there are no generally accepted tools for assessing severity and making decisions regarding newborn transfer. Objectives. To compare the capabilities of scales in relation to the decision about the non-transportability of newborns. Materials and Methods. The cohort study included data from 604 trips of the transport team of the neonatal resuscitation and consultation center. The assessment was carried out on the KSHONN, NTISS and TRIPS scales, the distribution of transportable and non-transportable patients was studied depending on the assessment for each scale. The calculation of the risk ratio of nontransportation was performed depending on the assessment on the scales. AUC ROC was calculated for all scales in relation to the decision of transport team about the patientʼs non-transportability. Results. The scor...
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care
BACKGROUND: Assessment of the clinical condition, prediction of risks and possible outcomes durin... more BACKGROUND: Assessment of the clinical condition, prediction of risks and possible outcomes during the transfer of newborns remains an important part of the work of transport teams. Respiratory disorders remain a significant indication for transfer to medical organizations of a higher level of care. AIM: To study the predictive value of the parameters of respiratory support in newborns requiring medical evacuation for the outcomes of treatment. MATERIALS AND METHODS: The observational, cohort, retrospective study included data from neonatal to patients on ventilators (286 newborns) in the period from August 1, 2017 to December 31, 2018. Anamnesis parameters, intensive care volume, respiratory support settings, and assessments on scales (KSHONN, NTISS, TRIPS) were evaluated. Analyzed: 24-hours mortality, 7 days mortality, hospital mortality, air leakage syndrome. The assessment and comparison of the predictive value of the parameters in relation to the hospital outcomes was performed...
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care, 2021
BACKGROUND: The safety of interhospital transfer of newborns remains one of the most important is... more BACKGROUND: The safety of interhospital transfer of newborns remains one of the most important issues of emergency neonatology. Assessment of risks associated with transfer is the basic concern of pre-transport preparation. AIM: This study aimed to assess and compare the predictive value of the KSCHONN, National Therapeutic Intervention Scoring System (NTISS), and TRIPS scales in predicting the risks associated with the interhospital transfer of newborns. MATERIALS AND METHODS: The cohort study included data from 604 visits of the transport team. The KSHONN, NTISS, and TRIPS scales were used in the assessments, the therapeutic actions of the transport team during transfer were evaluated, and mortality during the first day after assessments was analyzed. The area under the receiver operating characteristic curve (AUC ROC) was calculated for the KSCHONN, NTISS, and TRIPS scales in relation to the therapeutic actions of the transport team and first-day mortality. RESULTS: The predictiv...
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care, 2020
This literature review is devoted to the problem of predicting in-hospital mortality in newborns ... more This literature review is devoted to the problem of predicting in-hospital mortality in newborns with esophageal atresia (EA). According to epidemiological study data, in developed countries, the mortality rate in newborns with EA ranges from 9% to 11% over the past 20 years. Three classifications were developed, Waterston 1962, Montreal 1993, and Spitz 1994, to assess the prognostic significance of risk factors. They considered birth weight, the presence of concomitant congenital malformations and pneumonia, and the need for mechanical ventilation. The choice of a model for predicting outcomes depends on the level of health care and other factors, such as prematurity, low birth weight, late diagnosis, and infectious complications. These factors have a greater impact on patient survival in developing countries than in developed ones, where insurmountable risk factors come out on top: combined congenital malformations and very low birth weight. Also, the magnitude of diastasis betwee...
2019 Ural Symposium on Biomedical Engineering, Radioelectronics and Information Technology (USBEREIT), 2019
Neonatal Intensive Care Unit (NICU) patients require special support and care, which effectivenes... more Neonatal Intensive Care Unit (NICU) patients require special support and care, which effectiveness strongly relies on technology. Modern trends in care of preterm and term neonates include advanced imaging techniques, noninvasive monitoring, etc. The development of monitoring and imaging techniques makes predictive techniques more accurate and helps to prevent some complications. This paper briefly reviews current challenges of technologies used in NICU and investigates future perspectives in neonatal equipment development.
Medical news of the North Caucasus, 2020
Проведен анализ интенсивной, респираторной и нутритивной поддержки. Комплексный подход позволил у... more Проведен анализ интенсивной, респираторной и нутритивной поддержки. Комплексный подход позволил улучшить качество и уровень специализированной помощи детям с АП. Ключевые слова: атрезия пищевода, хирургия новорожденных, интенсивная терапия новорожденных Esophageal atresia (EA) is the most common congenital abnormality of the oesophagus. The survival rate of patients with this defect varies from 86.9 % to 95 %. Seventy eight newborns with EA were treated from 2011 to 2017; 58.9 % were male children, 48.7 % were premature, 51.3 % had associated anomalies. Mortality was 10.25 % and was associated with severe prematurity and sepsis. Direct esophagoesophagoanastomosis was formed in 60 (76.9 %) children, cervical esophagostomy with gastrostomy-in 17 (21.8 %) children. Postoperative morbidity occurred in 76,9 % of the population, including 4 (6.7 %) cases with anastomotic leak and anastomotic stricture in 43 (71.7 %), in those patients, who had anastomosis; recurrent fistula in 2 (2.6 %), pneumonia in 22 (28.2 %) and late-onset sepsis in 13 (16.7 %). Our study also highlights issues related to respiratory support, nutritional support and antibiotic therapy. Integrated approach has improved the quality and level of specialized care for children with EA.
Актуальность дополнительной профессиональной образовательной программы повышения квалификации вра... more Актуальность дополнительной профессиональной образовательной программы повышения квалификации врачей по теме «Интенсивная терапия острой дыхательной недостаточности в условиях коронавирусной пандемии» обусловлена необходимостью обучения специалистов здравоохранения навыкам своевременного выявления, диагностики и оказания медицинской помощи пациентам, инфицированным COVID-19
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care
BACKGROUND: The medical evacuation of premature newborns to institutions providing a higher level... more BACKGROUND: The medical evacuation of premature newborns to institutions providing a higher level of medical care results in the reduction of death risk. The use of pediatric intensive care units in level 2 organizations for the hospitalization of newborns can be a potential solution to the lack of neonatal beds in level 3 institutions. AIM: This study aimed to determine the predictors of the re-evacuation of newborns from level 2 medical organizations to level 3 institutions. MATERIALS AND METHODS: This observational, cohort, retrospective study included data of 284 cases of the evacuation of newborns from level 1 and 2 medical organizations without a pediatric intensive care unit to level 2 medical organizations with a pediatric intensive care unit. The sample was divided into two groups: the first group included patients who received the necessary therapy in level 2 medical organizations and did not require further evacuation to level 3 (n = 261), and the second group included pa...
Annals of Critical Care
INTRODUCTION: Assessment of the patient’s condition and prediction of outcomes is critically impo... more INTRODUCTION: Assessment of the patient’s condition and prediction of outcomes is critically important during pre-transport stabilization and remains the most complex challenges of the activities of transport teams. A significant variety of scales and different requirements for their application indicates that there is no consensus on the choice of a specific scale and predictive tool. OBJECTIVE: To study hospital outcomes in transported newborns, depending on the assessment on the TRIPS scale (Transport Risk Index of Physiological Stability for Newborn Infants). MATERIALS AND METHODS: The оbservational, cohort, retrospective study included data from 604 trips of the transport team to newborns consulted by resuscitation and consultative center from August 1, 2017 to December 31, 2018. The total sample was divided into groups depending on the assessment of the score, followed by a comparison of characteristics and outcomes in these groups. RESULTS: There is a significant difference i...
Annals of Critical Care
Introduction. Standardized assessment of the patient status and the decision on the possibility o... more Introduction. Standardized assessment of the patient status and the decision on the possibility of transfer is an essential part of the neonatal transport service. However, there are no generally accepted tools for assessing severity and making decisions regarding newborn transfer. Objectives. To compare the capabilities of scales in relation to the decision about the non-transportability of newborns. Materials and Methods. The cohort study included data from 604 trips of the transport team of the neonatal resuscitation and consultation center. The assessment was carried out on the KSHONN, NTISS and TRIPS scales, the distribution of transportable and non-transportable patients was studied depending on the assessment for each scale. The calculation of the risk ratio of nontransportation was performed depending on the assessment on the scales. AUC ROC was calculated for all scales in relation to the decision of transport team about the patientʼs non-transportability. Results. The scor...
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care
BACKGROUND: Assessment of the clinical condition, prediction of risks and possible outcomes durin... more BACKGROUND: Assessment of the clinical condition, prediction of risks and possible outcomes during the transfer of newborns remains an important part of the work of transport teams. Respiratory disorders remain a significant indication for transfer to medical organizations of a higher level of care. AIM: To study the predictive value of the parameters of respiratory support in newborns requiring medical evacuation for the outcomes of treatment. MATERIALS AND METHODS: The observational, cohort, retrospective study included data from neonatal to patients on ventilators (286 newborns) in the period from August 1, 2017 to December 31, 2018. Anamnesis parameters, intensive care volume, respiratory support settings, and assessments on scales (KSHONN, NTISS, TRIPS) were evaluated. Analyzed: 24-hours mortality, 7 days mortality, hospital mortality, air leakage syndrome. The assessment and comparison of the predictive value of the parameters in relation to the hospital outcomes was performed...
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care, 2021
BACKGROUND: The safety of interhospital transfer of newborns remains one of the most important is... more BACKGROUND: The safety of interhospital transfer of newborns remains one of the most important issues of emergency neonatology. Assessment of risks associated with transfer is the basic concern of pre-transport preparation. AIM: This study aimed to assess and compare the predictive value of the KSCHONN, National Therapeutic Intervention Scoring System (NTISS), and TRIPS scales in predicting the risks associated with the interhospital transfer of newborns. MATERIALS AND METHODS: The cohort study included data from 604 visits of the transport team. The KSHONN, NTISS, and TRIPS scales were used in the assessments, the therapeutic actions of the transport team during transfer were evaluated, and mortality during the first day after assessments was analyzed. The area under the receiver operating characteristic curve (AUC ROC) was calculated for the KSCHONN, NTISS, and TRIPS scales in relation to the therapeutic actions of the transport team and first-day mortality. RESULTS: The predictiv...
Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care, 2020
This literature review is devoted to the problem of predicting in-hospital mortality in newborns ... more This literature review is devoted to the problem of predicting in-hospital mortality in newborns with esophageal atresia (EA). According to epidemiological study data, in developed countries, the mortality rate in newborns with EA ranges from 9% to 11% over the past 20 years. Three classifications were developed, Waterston 1962, Montreal 1993, and Spitz 1994, to assess the prognostic significance of risk factors. They considered birth weight, the presence of concomitant congenital malformations and pneumonia, and the need for mechanical ventilation. The choice of a model for predicting outcomes depends on the level of health care and other factors, such as prematurity, low birth weight, late diagnosis, and infectious complications. These factors have a greater impact on patient survival in developing countries than in developed ones, where insurmountable risk factors come out on top: combined congenital malformations and very low birth weight. Also, the magnitude of diastasis betwee...
2019 Ural Symposium on Biomedical Engineering, Radioelectronics and Information Technology (USBEREIT), 2019
Neonatal Intensive Care Unit (NICU) patients require special support and care, which effectivenes... more Neonatal Intensive Care Unit (NICU) patients require special support and care, which effectiveness strongly relies on technology. Modern trends in care of preterm and term neonates include advanced imaging techniques, noninvasive monitoring, etc. The development of monitoring and imaging techniques makes predictive techniques more accurate and helps to prevent some complications. This paper briefly reviews current challenges of technologies used in NICU and investigates future perspectives in neonatal equipment development.
Medical news of the North Caucasus, 2020
Проведен анализ интенсивной, респираторной и нутритивной поддержки. Комплексный подход позволил у... more Проведен анализ интенсивной, респираторной и нутритивной поддержки. Комплексный подход позволил улучшить качество и уровень специализированной помощи детям с АП. Ключевые слова: атрезия пищевода, хирургия новорожденных, интенсивная терапия новорожденных Esophageal atresia (EA) is the most common congenital abnormality of the oesophagus. The survival rate of patients with this defect varies from 86.9 % to 95 %. Seventy eight newborns with EA were treated from 2011 to 2017; 58.9 % were male children, 48.7 % were premature, 51.3 % had associated anomalies. Mortality was 10.25 % and was associated with severe prematurity and sepsis. Direct esophagoesophagoanastomosis was formed in 60 (76.9 %) children, cervical esophagostomy with gastrostomy-in 17 (21.8 %) children. Postoperative morbidity occurred in 76,9 % of the population, including 4 (6.7 %) cases with anastomotic leak and anastomotic stricture in 43 (71.7 %), in those patients, who had anastomosis; recurrent fistula in 2 (2.6 %), pneumonia in 22 (28.2 %) and late-onset sepsis in 13 (16.7 %). Our study also highlights issues related to respiratory support, nutritional support and antibiotic therapy. Integrated approach has improved the quality and level of specialized care for children with EA.