WHO recommendations on live birth were adopted in Russia in 1992. Now live-born children are fetuses regardless the length of the pregnancy, with one or several signs of life: breath, heartbeat, umbilical palmus, clonus. Therefore it was necessary to improve technologies in developmental care. Successes in national emergency medicine and neonatology decreased practically twice the deaths of children under 1 year during the period from 2001 to 2014. However premature children after reanimation may have different conditions that we have to consider. The problem of bronchopulmonary dysplasia (BPD) as the pathological condition of immature bronchopulmonary system occur in response to breathing support such as ALV (Artificial Lung Ventilation), NCPAP (Nasal Continuous Positive Airway Pressure) and NIPPV (Nasal Intermittent Positive Pressure Ventilation) and has been studied for the last 50 years. Currently this problem is urgent.Methods52 children with bronchopulmonary dysplasia underwent RSV prevention care at our Clinic over the period from 2012 to 2015. Immunisation was done in the period of seasonal spread of disease to the children with high risk complications from RSV – who were borne on the 35th week of pregnancy and earlier, having bronchopulmonary dysplasia at the age of under 2 year. Every child from the group was given minimum 3 injections and maximum 4 injections with recommended by instruction interval in 30 days±10 days.patients characteristicsPalivizumab immunisation was done to 52 children: 26 boys and 26 girls. The age at the beginning of immunisation was 1–22 months. 10 children (19,2%) except with BPD had hemodynamically relevant heart diseases. Gestational age was 22–36 weeks. In the group of children immunised against RSV, children with critically low body mass at birth was 44,2% (23 children), very low – 19,2% (10 children) and 36,6% (19 children) low. The medicine was injected every month with interval 30±5 days in the amount of 15 mg/kg.ResultsEfficiency analysis of immunisation was conducted on the basis of data from patients who finished the course of immunisation (at least 3 injections). At the time of immunisation 11 children (21%) suffered from ARVI in mild or moderate forms, among them 3 were taken to hospital. The disease of none of the children taken to hospital with ARVI was not connected with RSV. Besides none of the children showed signs of side effects from the treatment.ConclusionsThese findings based on our experience of Palivizumab administration in patients with BPD demonstrate perspectives of treatments of the patients with intractable disease.

Anti-IgE therapy is used to treat children with severe uncontrollable bronchial asthma from 2001.Materials and methods13 children received anti-IgE therapy at our Clinic from 2008 to 2016. The study included taking clinical case history, laboratory instrumental and mathematic-statistic methods to analyse children, who went to the Clinic for injections 1 time per 2 weeks/ 1 time per 4 weeks. The number of injections was determined according to baseline level of total IgE and children’s baseline weight.patient description.13 children underwent anti-IgE therapy: 9 boys and 4 girls. At the beginning of the therapy all patients were diagnosed with atopic severe persistent uncontrollable bronchial asthma. All patients had polyvalent sensibilization. 9 (69.2%) patients were diagnosed with drug allergy. Age of bronchial asthma onset ranged between 1 and 11 years. Age at the beginning of the therapy – 6–17 years. Baseline level of total IgE ranged from 110–678 IU/ml. At the beginning of the therapy, all patients were receiving combined baseline therapy with high dose equivalent of fluticasone.Assessment of therapy efficiencyAfter first six months, the therapy decreased the frequency of severe aggravations in all patients, and improved external respiration function: increased forced expiratory volume 1 (%) from 82.0±15.2 before therapy to 91.0±25.3, increased peak exhalation speed (%) from 78.2±24.5 to 81.0±14.8. All patients began to show less need for B-agonists, declined frequency of daytime asthmatic attack, improved exercise tolerance; not a single clinically significant aggravation of disease was observed. Disease management assessment (Asthma Control Test) increased from 14.6±1.4 ?? 18.6±1.1. The medication therapy was safe: none of the children experienced adverse effects from injections.ConclusionThis data based on our internal experience of using Omalizumab as part of combined therapy for severe uncontrollable bronchial asthma treatment demonstrate the prospects for treatment of the most complicated group of patients. Improvement of disease management was achieved among all patients. However, taking into account pharmacological and economic features of anti-IgE therapy, a very stringent patient selection procedure should be in place of such therapy, and it may only be administered in case of severe uncontrollable course of the disease with proven atopic character and high risk of fatal asthma.