vestimИзвестия Национальной академии наук Беларуси. Серия медицинских наукProceedings of the National Academy of Sciences of Belarus, Medical series1814-60232524-2350The Republican Unitary Enterprise Publishing House "Belaruskaya Navuka"10.29235/1814-6023-2021-18-1-16-24vestim-729Research ArticleКЛИНИЧЕСКАЯ И ЭКСПЕРИМЕНТАЛЬНАЯ МЕДИЦИНАCLINICAL AND EXPERIMENTAL MEDICINEИнтегрированная программа оптимизации кислородного статуса головного мозга у новорожденных с респираторными расстройствами по данным региональной оксигенацииA comprehensive program of optimization the brain oxygen status in newborns with respiratory disorders based on targeting regional oxygenationСанковецД. Н.SankovetsD. N.

Санковец Дмитрий Николаевич – врач анестезиолог-реаниматолог

ул. Орловская, 66, 220053, г. Минск, Республика Беларусь

Dzmitry N. Sankovets – Anesthesiologist-intensivist

66, Orlovskaya Str., 220053, Minsk, Republic of Belarus

d.sankovec@gmail.comГнедькоТ. В.GnedkoT. V.

Гнедько Татьяна Васильевна – канд. мед. наук, доцент, заместитель академика-секретаря отделения медицинских наук

пр. Независимости, 66, 220072, г. Минск, Республика Беларусь

Tatyana V. Gnedko – Ph. D. (Med.), Associate Professor, Deputy Academic Secretary of the Department of Medical Sciences

66, Nezavisimosti Ave., 220072, Minsk, Republic of Belarus

hnedzko@mail.ruВитушкоА. Н.VitushkaA. M.

Витушко Андрей Николаевич – канд. мед. наук, врач анестезиолог-реаниматолог

ул. Орловская, 66, 220053, г. Минск, Республика Беларусь

Andrey M. Vitushka – Ph. D. (Med.), Anesthesiologistintensivist

66, Orlovskaya Str., 220053, Minsk, Republic of Belarus

andrej.vitushka@gmail.comСвирскаяО. Я.SvirskayaO. Ja.

Свирская Оксана Яковлевна – канд. мед. наук, заведующий отделением

ул. Орловская, 66, 220053, г. Минск, Республика Беларусь

Oksana Ja. Svirskaya – Ph. D. (Med.), Anesthesiologistintensivist,Head of the Department

66, Orlovskaya Str., 220053, Minsk, Republic of Belarus

aksana.svirskaya@gmail.comРеспубликанский научно-практический центр «Мать и дитя»National Scientific Practical Centre “Mother and Child”Национальная академия наук БеларусиNational Academy of Sciences of Belarus2021230220211811624Copyright © Санковец Д.Н., Гнедько Т.В., Витушко А.Н., Свирская О.Я., 20212021Санковец Д.Н., Гнедько Т.В., Витушко А.Н., Свирская О.Я.Sankovets D.N., Gnedko T.V., Vitushka A.M., Svirskaya O.J.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestimed.belnauka.by/jour/article/view/729

Использование метода NIRS позволяет неинвазивно получать информацию о кислородном статусе головного мозга, а следовательно, проводить коррекцию терапии, влияющей в том числе на кровоснабжение и доставку кислорода к головному мозгу.

Цель исследования ‒ разработать интегрированную программу динамического контроля кислородного статуса с учетом данных региональной оксигенации, а также комплекс эффективных лечебных мероприятий у новорожденных с респираторными расстройствами.

В исследование было включено 78 новорожденных детей с клинико-лабораторными проявлениями дыхательного расстройства. На протяжении раннего неонатального периода в дополнение к стандартному мониторингу кардио- респираторного статуса проводили параллельное измерение абдоминальной и церебральной оксигенации.

Разработанная программа основана на мультисистемном подходе к диагностике и оптимизации доставки и потребления кислорода головным мозгом посредством поддержания адекватного перфузионного давления, сердечного выброса, содержания кислорода и углекислого газа в артериальной крови новорожденных с респираторными расстройствами.

Включение в интегрированную программу мониторинга кислородного статуса, динамического контроля региональной оксигенации, а также разработанного на его основе комплекса эффективных лечебных мероприятий позволит повысить эффективность проводимого лечения у новорожденных с респираторными расстройствами.

NIRS provides the ability to obtain information about the brain oxygen status non-invasively. Therefore, potentially, this technology can make it possible to correct therapy that affects the blood and oxygen supply to the brain.

The aim of our study was to develop a guideline for a dynamic monitoring of the oxygen status based on regional oxygenation data, as well as an effective therapeutic tool for newborns with respiratory distress.

78 newborns with respiratory disorders were included (37 late preterm and 41 full-term) in this observational cohort study. In addition to a standard cardiorespiratory monitoring, a simultaneous monitoring of abdominal and cerebral oxygenation was performed during the early neonatal period.

The developed treatment guideline was based on a multisystem approach in diagnosis and optimization of the brain oxygen delivery and consumption. The proposed algorithm focused on maintaining an adequate perfusion pressure, cardiac output, oxygen, and carbon dioxide content in the arterial blood in newborns with respiratory disorders.

Implementing the developed treatment guideline in the neonatal intensive care units should increase the treatment effectiveness in newborns with respiratory disorders.

Implementation developed treatment guideline in the neonatal intensive care units should increase the effectiveness of treatment in newborns with respiratory disorders.

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The authors declare that there are no conflicts of interest present.