SOVREMENNAYA PEDIATRIYA.2016.1(73):67-70; doi10.15574/SP.2016.73.67 

Application integrated systems assessment severity of a newborn in critical condition 

Yashchenko Yu. B., Buriak O. G., Zabolotna I. E.

SSI «Scientific and Practical Centre of Preventive and Clinical Medicine» the State Affairs Department, Kiev, Ukraine

P.L. Shupik National Medical Academy of Post-Graduate Education Ministry of Health of Ukraine, Kiev, Ukraine

HSEE of Ukraine «Bukovinian State Medical University» Ministry of Health of Ukraine, Chernivtsi, Ukraine

Children consultative and treatment center SSI «Scientific and Practical Centre of Preventive and Clinical Medicine» the State Affairs Department, Kiev, Ukraine 

The aim the study. Assess the severity of status, aggressiveness and invasiveness of treatment, and predictable risk of death in newborns with respiratory disorders in critical conditions and to identify the main factors of aggression, which can lead to higher mortality rates and aggressive treatment of children in the intensive care unit. 

Material and methods. The study group included newborns with monitoring respiratory distress (84 children) due to different neonatal pathology. A control group of comparison consisted of 15 healthy newborns. To assess the invasiveness and aggressiveness of treatment, we used a scale NTISS (Neonatal Therapeutic Intervention Scoring). Assessment of the severity of the newborn was evaluated on a scale Score for Neonatal Acute Physiology (SNAP II and SNAPPE II) followed by calculation of the alleged risk of death. Adaptation abilities of the newborn evaluated using Apgar score at the first and fifth minutes after birth. The evaluation in lungs expirates state of prooxidant system. 

Results. Average NTISS score was 22.4±0.2 points, resulting in a core group of newborns were attributed to monitoring class III severity and aggressiveness of treatment. Average on a scale of SNAP II and SNAPPE II among newborns with respiratory failure was 21.4±2.55 points (prospective fatality rate of 3.8%). Found a positive correlation between the index of the expected mortality among a group of newborns and oxygen saturation indicator blend, which is inhaled by the child (r=0.751, p=0.000). An inverse correlation between the indices of aggressiveness and invasiveness of the treatment of neonatal group monitoring and evaluation of neonatal Apgar: the 1st r=-0.800, p=0.000 and 5th minute r=-0.750, p=0.000. 

Conclusion. At carrying out neonatal intensive care unit with severe respiratory failure should avoid the use of excessive concentrations of oxygen, since it is a risk factor for the toxic effect of oxygen on biostructure. In neonatal practice appropriate to apply a standardized rating scale severity of the condition in order to predict the results of treatment. 

Keywords: newborns, severity assessment, scale SNAP II and SNAPPE II, scale NTISS aggressive factors. 

REFERENCES

1. Buriak AG.. 2013. Assessment of the overall state of newborns with respiratory distress during the critical conditions by SNAP II and SNAPPE II scales. Sovremennaya pediatriya. 7(55): 38—41.

2. Buryak OG. 2013. StandartizovanI shkali otsInki tyazhkostI stanu hvorih pri kritichnih stanah ta Yih zastosuvannya v neonatalnIy praktitsI. KlIn ta eksperiment patol. XII; 2(44): 203—206.

3. Dubinina EE, Burmistrov SO, Hodov DA i dr. 1995. Okislitelnaya modifikatsiya belkov syivorotki krovi cheloveka, metod ee opredeleniya. Voprosyi med himii. 1: 24—26.

4. ShkurupIy DA. 2013. OptimIzatsIya IntensivnoYi sindromu polIorgannoYi nedostatnostI u novonarodzhenih ta otsInka YiYi efektivnostI. NeonatologIya, hIrurgIya ta perinatalna meditsina. ІІІ; 3(9): 78—81.

5. Yaschenko YuB, Buryak OG. 2012. Dihalna nedostatnIst u novonarodzhenih (patogenez, klInIka, neInvazivnI metodi dIagnostiki ta printsipi IntensivnoYi terapIYi). MonografIya. ChernIvtsI, MedunIversitet: 192.