PERINATOLOGY AND PEDIATRIC. UKRAINE. 2017.3(71):102-107; doi 10.15574/PP.2017.71.102
Kramarev S. O., Markov A. I.
Bogomolets National Medical University, Kyiv, Ukraine

Gastrointestinal complications in patients with severe forms of disease are associated with an increased risk of adverse effects and negatively affect the duration of treatment and the terms of rehabilitation of patients.
Objective — to study the frequency and clinical features of the gastrointestinal tract motility disorders in children with an acute neuroinfection.
Material and methods. The study is observational, retrospective, case-control. We analyzed medical records of in-patient children aged 1 month to 18 years with the acute neuroinfections (meningitis, encephalitis and encephalomyelopolyneuropathy).
Results. The study included 91 children with the acute infectious lesions of nervous system. GI tract involvement symptoms were observed in 72.5% of children. Constipation frequency was 48.4%. The time of constipation occurrence made up 80.7 90.0 hours. The episode duration was 90.5 34.2 hours. The direct correlation of constipation with the length of stay at the intensive care unit (rpb=+0.48, p=0.026) and nasogastric tube feeding (OR=+4.16 CI: 1.42-12.00) was revealed. Manifestations of diarrhea were observed in 34.1% of children and occurred in 161.5 111.7 hours. Duration of diarrhea episodes did not exceed 3 days (33.0 19.3 hours). The diarrhea correlated with the child's age (rpb=-0.24, p=0.0002), general condition severity (rpb=+0.19, p=0.037), length of stay at the intensive care unit (rpb=+0.42, p=0.046), functional status assessment based on the POPC scale (rpb=+0.19, p=0.037) and the LDH level (rpb=+0.67, p=0.0002).
Conclusions. Diarrhea and constipation often complicate the course of acute neuroinfection in children. The intestinal motility disorders are associated with the severity and duration of inpatient treatment and child's age. Their causes include stress-inducing sympathicotonia and cytotoxic actions. Further research is needed to find out the mechanisms of gastrointestinal disorders, their clinical and prognostic value in children with acute neuroinfections.
Key words: diarrhea, constipation, neuroinfection, children.

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