Topic number
2 . 2014
Intensive care of neonates
Content
Editorial

Editorial

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News of Cochrane database

News of Cochrane database (# 2, 2014)

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Neonatology news

Neonatology news (# 2, 2014)

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International practice

Modern approaches to preventing, diagnosing, and treating early-onset neonatal sepsis

Abstract

The review is devoted to the analysis of modern approaches to preventing, diagnosing, and treating earlyonset neonatal sepsis. In this review epidemiological evidences on prevalence of early-onset neonatal sepsis across the world are provided, main preventive services assessment of efficiency is given, clinical informative values of different laboratory tests are compared. This review including description of early-onset neonatal sepsis diagnostic screening methodology and decision-making behaviours of empirical initiation of antibiotic treatment.

Population pharmacokinetics of piperacillin/tazobactam in neonates and young infants

Abstract

Objectives. To develop population pharmacokinetic (PK) models for piperacillin/tazobactam in neonates and infants of less than 2 months of age in order to determine the appropriate dosing regimen and provide a rational basis for the development of preliminary dosing guidelines suitable for this population.

Methods. A two-stage, open-label study was conducted in neonates and infants less than 2 months of age in the neonatal intensive care unit (NICU). A total of 207 piperacillin and 204 tazobactam concentration–time data sets from 71 patients were analyzed using a nonlinear mixed-effect modeling approach (NONMEM VII). PK models were developed for piperacillin and tazobactam. The final models were evaluated using both bootstrap and visual predictive checks. External model evaluations were made in 20 additional patients.

Results. For neonates and young infants less than 2 months of age, the median central clearance was 0,133 and 0,149 L/h/kg for piperacillin and tazobactam, respectively.

Postmenstrual age (PMA) was identified as the most significant covariate on central clearance of piperacillin and tazobactam. However, the combination of current bodyweight (BW) and postnatal age proved to be superior to PMA alone. BW was the most important covariate for apparent central volume of distribu tion. Both internal and external evaluations supported the prediction of the final piperacillin and tazobactam PK models. The dosing strategy 44,44/5,56 mg/kg/dose piperacillin/tazobactam every 8 or 12 h evaluated in this study achieved the pharmacodynamic target (free piperacillin concentrations >4 mg/L for more than 50 % of the dosing interval) in about 67 % of infants.

Conclusions. Population PK models accurately described the PK profiles of piperacillin/tazobactam in infants less than 2 months of age. The results indicated that higher doses or more frequent dosing regimens may be required for controlling infection in this population in NICU.

Rewiews

Complications of bronchopulmonary dysplasia: pulmonary hypertension and cor pulmonale

Abstract

The review of literature on the basis of our own and literature sources presents modern information about the epidemiology, prognosis, diagnostic criteria, etiology, pathogenesis, clinical and instrumental diagnostics, prevention and therapy of severe complications of bronchopulmonary dysplasia (BPD) – pulmonary hypertension and cor pulmonale. There is a strong correlation between pulmonary hypertension/cor pulmonale and survival of children with BPD.

Therefore, early detection of these complications may improve the prognosis of these patients and be the basis for more aggressive respiratory support, administration vasodilators, catheterization of right heart, which can make late clinical outcomes better.

Selection of an enteral substrate for preterm infants

Abstract

In this review we have analysed international practices of utilization of semi-elemental formulae as a main enteral substrate for preterm infants

Original research

Features of anesthetic maintenance newborns with congenital diaphragmatic hernia

Abstract

Mortality, including post-operative, in newborns with congenital diaphragmatic hernia remains high despite improvements in intensive care and surgical tactics. Least little studied is the question of choice of anesthetic management tactics in this group of children. Presents an analysis of anesthetic management of infants with congenital diaphragmatic hernia, depending on the child’s condition and the nature of surgical intervention in a perinatal center.

SHARING EXPERIENCES

Role of breast milk fortifiers in post-natal nutrition of prematurely born children

Abstract
Nursing of very low and extremely low birth weight infants is one of the most difficult problems of modern perinatology. It is impossible to carry out this task without organization of feeding of this group of children. The aim of our research was to study clinical efficiency of breast milk fortifiers administration (human milk fortifier) when preterm infants feeding. In consequence of this clinical research (with includes 60 premature infants born at less than 33 weeks of gestational age with less than 1500 g birth weight) revealed the following advantages before other types of feeding. Mother and child solidarity in the course of breast feeding makes deep favorable mutual emotional pressure. It was succeeded to keep all breast feeding advantages and to provide preterm infants special needs in feedstuffs. Human milk fortifiers administration provides higher body weight gain intensity; reduces length of hospital stay. It should not go unnoticed high tolerability and lack of complications at its medication usability was noted. Human milk fortifier divorce with small quantity of breast milk and that is especially important for very low and extremely low birth weight infants feeding. All above-mentioned allows recommending human milk fortifiers «PRE NAN FM 85» administration with breast milk in neonatal practice.

Original medical records administration in neonatal departments

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Protocol of therapeutic hypothermia following perinatal asphyxia management

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Clinical practice guidlines

Diagnosis and conservative treatment of necrotizing enterocolitis in newborn (project of clinical practice guidelines)

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Readers questions

Readers questions

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First Euro-Asian neonatal forum report

First Euro-Asian neonatal forum report

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Announcements

Announcements (# 2, 2014)

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Information

Information

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All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)

CHIEF EDITOR
CHIEF EDITOR
Degtyarev Dmitriy Nikolaevich
Doctor of Medical Sciences, Professor, Deputy Director for Scientific Research of the V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation, Head of the Chair of Neonatology at the Clinical Institute of Children's Health named after N.F. Filatov, I.M. Sechenov First Moscow State Medical University, Chairman of the Ethics Committee of the Russian Society of Neonatologists, Moscow, Russian Federation

ORCID iD 0000-0001-8975-2425

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