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The aim of the research. To study the effect of invasive and non-invasive lung ventilation in full-term infants with moderate and severe HIE on cerebral perfusion and central hemodynamics. Materials and methodsTo study the effect of noninvasive lung ventilation on central hemodynamics and cerebral perfusion, 60 infants with moderate and severe YIE were examined, thirty of them had early tracheal extubation 72 hours after birth and were transferred to non-invasive nasal lung ventilation with intermittent positive pressure (NIPPV), another 30 new-borns formed a comparison group. They had a traditional MV. Results No differences were found between the mean blood pressure and heart rate in the newborn core and comparison group, both during the first day of stay and during the fourth day, when the core group infants were extubated and transferred to NIPPV, but the mean BP level increased significantly after the core group infants were transferred to NIPPV, compared to the values of this indicator during the first day (p<0.05). The study of central hemodynamics indices in the new-born infants of the main group within a day after extubation and transfer to NIPPV did not reveal any differences in comparison with the new-born comparison groups. Stroke volume, heart index and left ventricular ejection fraction did not differ in the main group and comparison group. When studying the effect of non-invasive lung ventilation on brain perfusion, no reliable differences between the study groups were also found. Conclusions. No statistical difference was found between НI and EF in the main group and the comparison group, respectively. Non-invasive ventilation in NIPPV mode does not affect cerebral perfusion indices compared to conventional ventilation NIPPV and can be used in intensive care of new-borns with HIE

Assessment of renal function in newborns is extremely important and at the same time challenging due to the unique body structure, increased vulnerability and rapid growth of the latter. However, for the early detection of acute kidney injury (АКI), rational dosing of drugs and safe drug therapy, the identification of early markers of renal dysfunction is essential.The objective is to evaluate the prognostic value of serum biomarkers for the early diagnosis of АКI in newborns with hypoxic-ischemic encephalopathy against the background of therapeutic hypothermia and preventive use of methylxanthines.Materials and Methods. A single-center, prospective, randomized trial involving 44 neonates with АКI requiring therapeutic hypothermia and prophylactically receiving caffeine citrate or theophylline to prevent АКI progression was conducted in from 2019 to 2022 on the basis of the NICU of Zaporizhzhia Regional Clinical Children's Hospital.Laboratory analysis of blood serum samples was performed on day 1, day 3 and 5 from birth, creatinine (Cr) and cystatin C (CysC) levels and their associations with the development of АКI were determined according to the neonatal criteria of the 2012 KDIGO guideline.Statistical analysis was performed using Statistica 13.0 program, TIBCO Software Inc. (license number JPZ804I382130ARCN10-J) and Microsoft Excel 2013 (license number 00331-10000-00001-АА404). The probability of the difference in absolute values of mean values was determined using non-parametric methods of statistical analysis: the Mann-Whitney U-Test for unrelated groups and the Wilcoxon signed-rank t test for related groups. Statistical significance was defined as p < 0.0500.The study was performed in accordance with the moral and ethical standards established by the IGH / GCP guidelines, the World Medical Association Helsinki Declaration, adopted in 1964 and amended in 1975, 1983, 1989, 1996 and 2000, The European Convention of Human Rights and Biomedicine and the legislation of Ukraine. The protocol was approved by the Medical Ethics Commission at Zaporizhzhia State Medical University. The study was performed as part of the research project "Optimization of diagnostics and intensive care of polyetiologic lesions of the brain, gastrointestinal tract, and kidneys in newborns and older children" (State registration number O118U007142) of the Pediatric Surgery and Anesthesiology Department of the State Institution "Zaporizhzhia State Medical University of the Ministry of Health of Ukraine."Results and their discussion. In general, AKI according to KDIGO developed in 5.00 (11.36 %) neonates out of 44.00 (100.00 %), stage 0 was found in 39.00 (88.64 %). 4.00 (9.09%) newborns had stage I, and 1 (2.27%) developed stage II; the data obtained were similar: p = 0.7872; U = 230.00. None of the patients progressed to stage III.In the newborns with preserved renal function during the study there was a decrease in Cr and a predictable, by this marker, increase in GFR. A statistically significant increase in Cr level and decrease in GFR was found in the newborns with renal dysfunction on days 3 and 5 of the study. Cr level progressed from baseline 1.07 (0.87; 1.10) mg/dl to 1.13 (0.86; 1.25) mg/dl on day 3 and to 1.40 (1.15; 1.82) mg/dl on day 5, while GFR decreased from 19.76 (19.07; 22.90) ml/min/1.73m2 to 17.97 (13.84; 24.42) ml/min/1.73m2 on day 3 and was 12.38 (11.12; 17.54) ml/min/1.73m2 on day 5, with p < 0.0500.CysC progressively decreased in the neonates without AKI from 2.50 (2.20; 2.60) ng/ml to 2.25 (2.08; 2.49) ng/ml, p = 0.0095; while in the neonates with AKI the level of this marker did not change and was 2.56 (2.41; 2.70) ng/ml on day 1 and 2.42 (1.89; 2.45) ng/ml on day 5, p = 0.2963. As this marker changed, eGFR (CysC) increased progressively in the cohort of patients without kidney damage but did not change in the other group.The diuresis rates in the newborns of both groups did not differ, being ≥ 1.5 ml/kg/h, which is probably due to methylxanthine therapies, p ≥ 0.0500.Conclusions. CysC assessment did not provide additional information on the development of acute kidney injury in neonates (nAKI) in the first 5 days of life, which would have allowed a quick decision to change the intensive care program. Further studies involving newborns who did not receive prophylactic therapy are needed.

Ключевые слова: некротический энтероколит, флегмона, паранефрит, новорожденный.

Necrotic enterocolitis is a common disease of the newborn children, which requires an emergency treatment. The results of children treatment depend on many factors, especially from well-timed diagnostics in case of transition from therapeutic to surgical stage. There was noted the tendency to lethality reduction because of necrotic enterocolitis (17% in developed countries, 42% in countries with low- and middle levels of economy) over the past decade. The authors followed-up 42 children with the diagnosis of necrotic enterocolitis. Sepsis, inflammatory bowel disease, toxic products in its lumen are the main source of severe condition of the child. The antibacterial and detoxication therapies should be performed for the newborn child with necrotic enterocolitis on admission to the hospital. An operative treatment have to be carried out in case of lack of condition improvement.