Backgroun. We conducted a comparative clinical study to evaluate the prophylactic effects of micafungin (MCFG) and fluconazole (FLCZ) on the incidence of fungal infections in extremely low birth weight infants who were born at a gestational age of less than 26 weeks and weighed less than 1000 g.

Methods. With a combination of enteral administration of miconazole (6 mg/kg/day), FLCZ and MCFG were administered intravenously at a dose of 5 mg/kg/day and 3 mg/kg/day, respectively. The prophylaxis was classified as a failure when fungal infections were identified within the first 21 days after birth.

Results. The prophylaxis was successful in seven of 18 cases (39%) in the FLCZ group and 15 of 21 cases (71%) in the MCFG group, indicating that the success rate was significantly higher in the latter group.

Background and aim. Binasal cannula that deliver to patient humidified heated high gas flows becoming recently a popular form of respiratory support for infants and young children. Despite the absence of sufficient evidence of efficacy and safety from randomized trials, the method adopted by many neonatal units as a possible alternative to existing methods of non-invasive respiratory therapy.

Aim of the study was to determine the feasibility of usage high flow nasal cannula (HFNC) in population of the near term infants with respiratory disorders and to compare outcomes to a historical control group of who received head box oxygen or low flow nasal cannula.

Methods. We performed a matched case-control study with historical control group received treatment in the same unit for respiratory distress. High flow system at flow rate 10 l/min was used as a first line respiratory treatment for a 27 premature infants ≥34 weeks gestation, with respiratory distress. Criteria for treatment failure and indications for escalation of respiratory support was SpO2 <90% and FiO2 >0,6 or frequent apnoea.

Results. The median birth weight, gestational age and Downes score were similar in both groups. Duration of need of oxygen was significantly lower in HHFNC group (p<0,001). Treatment failure rate was lower in the HHFNC group (p=0,05). The was no significant difference in deaths, pneumothorax rate and nasal trauma between the groups.

Background. The presence of hemodynamically significant patent ductus arteriosus (PDA) in very low birth weight preterm infants may lead to the development of severe complications and even death. Priority in care of hemodynamically significant PDA during early postnatal life is given to the conservative treatment by use cyclooxygenase inhibitors. However, conservative treatment of hemodynamically significant PDA may also be accompanied by the development of some complications, despite the high efficiency (70–80%).

Purpose. To evaluate the results of pharmacological closure of PDA by use ibuprofen in preterm infants in Yaroslavl region.

Materials and methods. In a retrospective clinical study included medical data about 17 preterm infants with gestational age less than 34 weeks. All children were born in the Regional Perinatal Center of Yaroslavl region from January, 1, 2012 to October, 1, 2012 and after birth were admitted to the neonatal intensive care unit of the same clinic. All children underwent serial abdominal circumference measurement, echocardiography, Doppler study of blood flow in the middle cerebral artery with calculation of the resistance index (IR). Ibuprofen was administered from2 to 6 day of life, taking into account contraindications.

Results. The effectiveness of ibuprofen using for closure of the hemodynamically significant PDA was 77,8%. A significant decrease in IR was noted during treatment with ibuprofen, which may be considered as an additional criterion for the effectiveness of the conservative therapy. Among the complications during conservative treatment of the hemodynamically significant PDA frequently reported necrotizing enterocolitis (NEC), and thrombocytopenia. A low platelet count before treatment was correlated with their more significant decline during therapy with ibuprofen. Abdominal circumference increased signifi cantly during conservative treatment of the hemodynamically significant PDA in children who developed NEC later. No adverse effects of ibuprofen treatment found on renal function.

Objective. Finding ways to nutritional support in preterm children is a priority in the care of newborns with low birth weight. To study the clinical efficacy of breast milk fortifier (BMF) for feeding premature infants with a gestational age less than 33 weeks. Methods. 3 clinical groups were identified to evaluate the advantages of using a breast milk fortifier: 1st (control) group (n=10) – newborn infants on exclusive breast feeding; 2nd group (n=20) newborn infants receiving breast milk fortified with a BMF; and 3rd group (n=10) newborn infants receiving breast milk in combination with preterm Infant Formula. Clinical efficacy of breast milk fortifier was evaluated on the following criteria: the dynamics of the general condition of the child, daily weight gain, BMF tolerance by the presence and frequency of regurgitation and colic, stool frequency, presence of complications such as abdominal swelling. The duration of hospital stay among children of different groups was as well evaluated.

Results. Daily weight gain in children who received breast milk with BMF was higher than in the group of children who received breast milk in combination with preterm Infant Formula and significantly higher compared with the group of children who were exclusively breastfed. Breast milk fortified with BMF was well tolerated: the number of colic and regurgitation was significantly lower in the second clinical group. Tendency to constipation and a decrease in stool frequency was observed in 50% of children who were fed breast milk in combination with preterm Infant Formula. Duration of hospital stay of infants from the 2nd clinical group on average was three days less compared to the control groups.

Findings. The following benefits of using breast milk fortified with BMF against using only breast milk or breast milk in combination premature Infant Formula were identified: the advantages of breastfeeding are preserved, infants showed a more intense weight gain, good tolerability of BMF, no complications, reduced duration of hospital stay, ease of use was noted.