Neonatal respiratory distress syndrome due to surfactant deficiency is associated with high morbidity and mortality in preterm infants, and the use of less invasive surfactant administration (LISA) has been increasingly studied. This meta-analysis found that LISA via thin catheter significantly reduced the need for mechanical ventilation within the first 72 hours [relative risk (RR) = 0.677; p=0.021], duration of mechanical ventilation [difference in means (MD)] = -39.302 hours; p<0.001), duration of supplemental oxygen (MD = -68.874 hours; p<0.001), and duration of nasal continuous positive airway pressure (nCPAP; MD = -28.423 hours; p=0.010). A trend toward a reduction in the incidence of bronchopulmonary dysplasia was observed (RR=0.656; p=0.141). No significant difference in overall mortality, incidence of pneumothorax, or successful first attempts was observed. LISA via thin catheter significantly reduces the need for mechanical ventilation within the first 72 hours as well as the duration of mechanical ventilation, supplemental oxygen, and nCPAP. LISA via thin catheter appears promising in improving preterm infant outcomes.

Preterm infants, especially very low birth weight (VLBW; <1500 g) and extremely low birth weight (ELBW; <1000 g) infants, are susceptible to growth failure in postnatal life if nutritional demands are not met. Poor postnatal growth in preterm infants is associated with adverse neurodevelopmental outcomes during childhood. Early parental nutrition is of paramount importance to provide appropriate protein and energy in VLBW infants when enteral nutrition is not feasible or is suboptimal. An "early and aggressive" approach of parenteral nutrition in preterm infants has been shown to prevent protein catabolism, induce positive nitrogen balance and improve postnatal growth.

In the scientific Literature, much attention is paid to nutritionaL support. The accumuLated experience in the use of enteraL and parenteraL nutrition in patients in intensive care units of neonates shows a high efficiency of nutritionaL support. In recent years, it has been proven that the nutritionaL therapy program shouLd incLude not onLy amino acids, Lipids, vitamins and trace eLements, but aLso nutrients with various pharmacoLogicaL effects. Conducting adequate nutrition in a newborn protects him from serious compLications and promotes adequate growth and deveLopment.

The idea of using a new drug in neonataL practice, the effectiveness of which has aLready been proven in the popuLation of aduLt patients, is justified when the use of a new drug appears pathogeneticaLLy justified and can avoid dangerous and frequent compLications of therapy.

In recent years, active research has been carried out on the roLe of gLutamine in the deveLopment and prevention of diseases in newborns, and this probLem remains urgent.

The problem of acute renal failure in newborns remains relevant, despite the emergence of new diagnostic methods and the identification of predictors, indicating kidneys failure. The question of treatment tactics remains unresolved as well. According to clinical data, in preterm infants this tactic is not able to provide full recovering of the kidneys, so further drugs development is needed to affect nephrogenesis. This in turn requires to employ approaches for experimental modeling of neonatal pathologies in animals. In this review, we consider the possibility of using neonatal rats as neonatal AKI model and compare nephrogenesis and physiology of the kidney of the newborn rat and human. Different mechanisms of kidney damage and developing of its laboratory models are discussed , as well as the possibility of the diagnosis of AKI by using new biomarkers (NGAL, Kim-1) and prospects of cell therapy after testing in animal models are suggested.

Post-discharge feeding of preterm infants is a challenging task for paediatricians. The main goal of nutrition is providing the catch-up growth. The study results confirm the robust association between the growth rate of preterm babies and further neurocognitive development. Breast milk is the ultimate nutrition for preterm infants. However, it does not always meet the high needs of premature babies in terms of nutrients. Considering the fact that guidelines on nutrients supply for preterm infants after hospital discharge do not exist and the data on the feeding duration is quite contradictory, the individual approach based on growth parameters is recommended as the rule of thumb.

The probLem of acute renaL injure (AKI) in newborns remains reLevant, despite the deveLopment of modern technologies and the introduction of new methods of treatment. Acute renaL injure, as an independent nosoLogicaL unit, is rare in newborns. In most cases, AKI deveLops against a background of septic processes, severe hypoxic damage. In connection with the reveaLed discrepancy between the estimated need for repLacement renaL therapy (RRT) and the true number of chiLdren entering treatment at the bLood gravitationaL surgery and hemodiaLysis center St. VLadimir's chiLdren's hospitaL, as weLL as the smaLL number of cases of RRT in newborns in other hospitaLs in Moscow, an anonymous survey among resuscitators and neonatoLogists at resuscitation departments of Moscow maternity hospitaLs was conducted. The aim of the questionnaire was to assess the awareness and vigiLance of the neonatoLogists and resuscitators of the intensive care unit of the maternity hospitaL (stage 1). The second stage intensive care units, surgicaL resuscitation units with neonataL beds, assess the wiLLingness of speciaLists to participate in the RRT.

70 neonatoLogists were interviewed, 32 of them were empLoyees of the intensive care unit of maternity hospitaLs (1st stage of nursing), 18 peopLe - of intensive care units of the second stage of nursing, 16 peopLe -speciaLists from surgicaL resuscitation unit outfitted for newborns treatment, the remaining 4 empLoyees were from other different departments. The resuLts of the questionnaire reveaLed Low awareness, Leading to untimeLy detection of AKI, and in some cases, inadequate treatment tactics. At the same time, the majority of the respondents demonstrated satisfactory LeveL of knowLedge about RRT methods and greater compLiance with diaLysis therapy. This indicates the need to conduct educationaL activities on the probLems of the AKI among the aforementioned contingent of speciaLists.

Despite the fact that in the last decade published a number of research works demonstrated the prospect of using the method in preterm infants 28-34 weeks of gestational age (GA), to the present time is not accumulated sufficient clinical data to recommend routine transcutaneous bilirubin measurement in preterm infants, with the exception of the group of late preterm GA more than 35 weeks. The approach to the use of the method practically does not differ from that described previously for full-term newborns. The aim of this study was to compare transcutaneous and invasive methods for the determination of bilirubin in the group of premature infants with gestational ages (28-34 weeks), who didn't receive phototherapy.

The research was conducted in ORITN of two medical organizations of the third functional level for uniform design. In the research included preterm children of GA 28-34 weeks, irrespective of the body weight, sex of child and a clinical state, except for the patients who demanded carrying out phototherapy. Sampling of capillary and venous blood on a research and also transcutaneous measurement of a bilirubin were spent consistently within a short period of time (in the range ±30 min).

Concentration of a total bilirubin in venous blood defined by automatic biochemical Dimension RxL Max analyzers (Siemens, Germany) and VA-400 (Biosystems, Spain) with the use of standard sets of reactants recommended by the producer. Direct spectrophotometric assessment of level of a bilirubin in a capillary blood was carried out by the ABL800 FLEX analyzer (Radiometr, Denmark) in an automatic mode, transcutaneous measurement of level of a bilirubin was realized by a transcutaneous bilirubinometr - Drager JM-105 (production of the USA). Data of spectrophotometric measurements were compared with results of standard biochemical blood test on a bilirubin. If concentration of bilirubin in serum of blood was <50 or >270 pmol/l (i.e. I exceeded the limit of the guaranteed measurement accuracy by the spectrophotometric method), then tests were excluded from a research.

The study included 65 preterm newborns with gestational age from 28 to 34 weeks, body weight at the birth in the range from 880 to 2720 g. The research was conducted from 2 to 14 day of life before the beginning of phototherapy.

Results. Very high degree of direct correLation between the concentration of totaL biLirubin (TB) measured by standard biochemicaL method, and the transcutaneous measurement of totaL biLirubin concentration obtained from the chest (TcBc) - r=0.94 at p<0.05 and from the forehead (TcBf) - r=0.90 at p<0.05 is reveaLed. Comparison of the concentration of TB measured by standard biochemicaL method and the concentration of TB measured by direct spectrophotometric method of a sampLe of capiLLary bLood by the ABL800 FLEX anaLyzer has reveaLed aLso very high degree of direct correLation (r=0.94 at p<0.05).

Despite Limitation of seLection, we received resuLts, which demonstrate that transcutaneous measurement of LeveL of totaL biLirubin in bLood at preterm chiLdren with GA 28-34 weeks which didn't receiving phototherapy can be a good aLternative to the standard methods of Laboratory monitoring of LeveL of a hyperbiLirubinemia at this category of chiLdren.

The aim of the study was to determine the clinical and prognostic value of the cerebral oximetry method in newborns with malformations of internal organs in the perioperative period.

Material and methods. 160 histories of newborns development were analyzed to determine predisposing factors to the development of perinatal CNS damage. Cerebral oximetry was performed in 68 patients. The chil­dren were divided into 3 groups: 1 group - newborns with malformations of internal organs (from the Depart­ment of Neonatal Surgery) and brain damage (n=20), 2 group - newborns with malformations of internal organs (from the department of neonatal surgery) without brain damage (n=20), 3 group - control group, - healthy term infants from the Department of Physiology of the V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation (n=28). All patients from groups 1 and 2 underwent surgical correction of malformations of internal organs in the early neonatal period (0-7 days of life). Cerebral oximetry for newborns with malformations of internal organs from Groups 1 and 2 was performed three times: 1 day of life, 1 postoperative and 7 postoperative days. Children from the control group of cerebral oximetry were performed singly in a dream, on average 2.1±1.2 days of life. Patients from all 3 groups underwent neurosonography.

Results. Analysis of 160 cases of neonatal disease revealed that CNS lesions occurred in 45% of cases (72/160 children). The following predisposing factors were identified: severe and moderate asphyxia at birth (odds ratio = 8), duration of anesthesia for more than 1 hour (odds ratio = 6), repeated surgery (odds ratio = 4), and duration of mechanical ventilation more than 2 days (odds ratio = 17). The analysis of the cerebral oximetry revealed differences between group 1 and the control group in both hemispheres for 1 day of life, 1 and 7 post­operative days, which were statistically significant (p<0.05). The differences between group 2 and the control group also turned out to be statistically significant, with the exception of the cerebral oximetry indicator for the right hemisphere for 1 postoperative day (p=0.0584). It should be noted that both in the preoperative period and on days 1 and 7 of the postoperative period, the level of oxygenation of the brain tissue in children with malfor­mations of internal organs was significantly higher than in healthy newborns. Interhemispheric asymmetry was estimated. Oscillations of the cerebral oximetry between the right hemisphere in the range of 1-2% have been revealed, both in the study groups with malformations of internal organs and in the control group.

Conclusion. The cerebral oxygenation in children with malformations of internal organs, included in our study, was higher in the preoperative and postoperative period than in healthy children, which could be one of the reasons for transient neurologic disorders. In addition, the development of disorders contributed to: the transferred asphyxia, the duration of anesthesia for more than an hour, repeated surgical interventions and the duration of mechanical ventilation for more than 48 hours.

In the article possibilities of ultrasound investigation in lungs pathological states diagnosis that accompany and precede bronchopulmonary dysplasia development: pneumonia, atelectasis, pneumothorax, pulmonary interstitial emphysema and hydrothorax are shown. Comparison of clinical picture and ultrasound signs of pulmonary tissue damage in patients with bronchopulmonary dysplasia was performed.

Stroke in children is surprisingly common, so the question about diagnostics of perinatal arterial ischemic stroke remains relevant. The difficulties of its diagnosis are determined by the presence in the newborn of a large number of pathological conditions that can be realized by acute cerebral ischemia. Our research shows that the most frequent localization of ischemic damage is cortical-subcortical area of the left middle cerebral artery. If there is an appropriate anamnesis, manifestation of seizures, hemiparesis, oppression syndrome, MRI with MR angiography in standard modes is recommended. Sonography can be used as supporting method of investigation. After diagnosing PAIS dynamic control of parenchyma state and blood velocity in cerebral arteries should be managed daily in first 5 days and then every 5-7 days. MRI should be carried out in 14 days after diagnosing PAIS for assessment consequences.

The articLe presents a cLinic case of congenitaL generaLized herpes-viraL infection in fuLL-term maLe newborn. The infection was deveLoped aLong with cLinic features of congenitaL pneumonia, carditis, encephaLitis, muLtipLe organ faiLure syndromes, immunodeficiency state with hematosis apLasia. For treatment anti-viraL and antibacteriaL drugs, Leucopoiesis stimuLators and therapy of muLtipLe organfaiLure syndromes were used.

Rotavirus infection is one of the main cases in the morbidity distribution of acute enteric infections. The difficuLties in detection of virus carriers and convaLescents Lead to Low registration of rotavirus gastroenteritis. The study of infection conditions by rotaviruses for infants showed that maternity hospitaLs are the most commonLy pLaces of infection for infants. To know epidemioLogicaL features of rotavirus infection in infants is necessary for earLy diagnosis and treatment of its muLtipLe variants, taking reLevant preventive measures. SeasonaL pickups of morbidity, Long hospitaL stay of infants and overcrowding of wards contribute to nosocomiaL infections. MedicaL staff pLays significant roLe in rotavirus transfer. It is necessary to organize and deveLop of measures oriented to detection and deactivation of source, disruption of transmission of infection and susceptibLe groups. Vaccination is the most effective method for morbidity rate controL.