[THE IMPACT OF PERINATAL METABOLIC DISORDERS CHOICE MODE MECHANICAL VENTILATION IN NEWBORNS.]

THE AIM: To study the influence of perinatal metabolic disorders, metabolism on the choice of mode of artificial lung ventilation in newborns. MATERIALS AND METHODS: The study included 73 neonates with severe respiratory failure, therefore, all children underwent ALV Depending on the mode ofventilation, patients were divided into two groups: group 1 - 33 neonates who were at the beginning of treatment on a ventilator in the SIMV mode, then led to HFO ventilation; group 2 - 40 neonates who underwent only the SIMV The study used following research methods: analysis ofpregnancy anamnestic data; clinical assessment of the newborn's condition at birth including Apgar score (AS) on the 1st minute after birth; registration of changes of mode and parameters of mechanical ventilation: a mathematical calculation of oxygenation index (0I); determination of triglycerides and cholesterol in the central venous blood of newborns in thefirst hours ofpostnatal life and on the 5th day of life Results: At birth the triglycerides level in the blood of newborns is reduced and didn't differ signicantly between the groups. Along with this,. the newborns of 1st group remained impaired oxygen status, severe hypoxia, progressive increase of 01 not resolved in the conventional ventilation, which is an indication to lead the children to HFO ventilation. CONCLUSION: Asphyxia at birth, resistant to therapy, characterized by worsening hypoxemia, impaired lung function oxygenation, the increase of lactate in the blood, deep base deficiency, disorders of the metabolism of triglycerides and cholesterol and high oxygenation index are testimony to the high-frequency oscillatory ventilation. Pathogenetically justified the use of this kind of respiratory theory, not only during RDSN.

[An alternative method of treatment for the icteric-anemic form of neonatal iso-immunization to rhesus factor].

Neonatal iso-immunization to rhesus factor is a rather well studied pathology. Negative rhesus factor in a pregnant women is a ground to determine anti-D-antibody titers during pregnancy, which allows one to define the tactics of pregnancy management and neonatal treatment just after birth.

[Lung morphological changes in premature neonates with hyaline membrane disease due to the use of exogenous surfactants during mechanical ventilation].

A complex of studies was used in 4 groups of premature babies to study lung tissue morphological changes in hyaline membrane disease, by applying exogenous surfactants during mechanical ventilation. Background diseases, pre- and intranatal risk factors, the babies' longevity, and the specific features of lung tissue and forming hyaline membranes were ascertained. Exogenous surfactants were found to have a blocking effect on the formation of hyaline membranes under mechanical ventilation.

[Intracardiac hemodynamic changes in the newborns with respiratory distress syndrome].

The paper provides the results of intracardiac circulation ultrasound study in 37 preterm neonatal infants, including 24 patients with severe respiratory distress syndrome (RDS), receiving the exogenous surfactant Curosurf in the complex therapy of the disease. A control comprised 12 apparently healthy preterm neonates who had no clinical signs of RDS in the early adaptive period or artificial ventilation (AV). Both groups were similar in the major anthropometric characteristics and gestational age. The objective of this investigation was to make Doppler echocardiographic study of blood flow through all cardiac valves in the newborn with RDS during AV. The investigation indicated that the neonates with severe RDS had increases in peak blood flow velocity and in peak pressure gradient through the valves of the great vessels: the aorta and pulmonary trunk, and abnormal regurgitation flow mainly through the pulmonary arterial valve, which was a sign of intensive hemodynamic adaptation in the acute phase of disease. By the third day of life, some neonatal infants without clinical signs of RDS were observed to have signs of intensive hemodynamic adaptation: increases in peak blood flow velocity and in peak pressure gradient through the valves of the pulmonary trunk. Irrespective of the specific features of the course of an early neonatal period, neonatal infants need Doppler echocardiographic monitoring for the evaluation of intracardiac hemodynamics.