Y. Sokolov, A. Efremenkov, Dmitrii V. Donskoy, R. A. Akhmatov, A. P. Zykin, Muhammad Kh. Kaufov, A. Shapkina, Kamila A. Barskaya
{"title":"Pancreatic cysts in children: diagnostical and surgical tactics","authors":"Y. Sokolov, A. Efremenkov, Dmitrii V. Donskoy, R. A. Akhmatov, A. P. Zykin, Muhammad Kh. Kaufov, A. Shapkina, Kamila A. Barskaya","doi":"10.17816/psaic1506","DOIUrl":"https://doi.org/10.17816/psaic1506","url":null,"abstract":"BACKGROUND: Surgical treatment of pancreatic cysts is one of the most difficult procedures in pediatric surgery. In children with pancreatic cysts, the issues of differential diagnosis and determining the connection of the cyst cavity with the main pancreatic duct remain problematic. Recent publications have focused on the use of endoscopic ultrasonography in pediatric practice to visualize the parenchyma and the ductal system of the pancreas with high accuracy. \u0000AIM: This work aimed to study the results of treatment of children with cystic formations of the pancreas using modern radiation diagnostic methods and minimally invasive surgical technologies. \u0000MATERIALS AND METHODS: Analysis was conducted on the results of treatment of 66 patients consisting of 30 boys (45.5%) and 36 girls (54.5%) aged 6 months to 18 years (average age of 10.9 5.2 years) with extraparenchymatous and intraparenchymatous pancreatic cysts. \u0000RESULTS: Multispiral computed tomography (Se 90%, Sp 91%, and Ac 91%; p 0.05) and magnetic resonance imaging (Se 96%, Sp 94%, Ac 95%; p 0.05) are the most informative for the differential diagnosis of intra- and extraparenchymatous pancreatic cysts. For thin-walled extraparenchymatous cysts up to 6 cm in size, conservative therapy is effective in the early period of the disease. External (42.4%) and internal (51.3%) drainage of cysts can be performed when the existence of pancreatic pseudocysts is prolonged (more than 2 months). Indications for simultaneous longitudinal pancreaticoejunostomy may occur in 9.5% of patients. Excision of the pseudocyst with pancreatic resection may be required in 4.7% of cases. For intraparenchymatous cysts, 33.3% of cases require the enucleation of cystic formation, 25% require the distal splenoserving resection of the pancreas, 25% require the central resection of the pancreas with the imposition of distal pancreatoejunoanastomosis, and 12.5% require pylori-preserving pancreatoduodenal resection. Approximately 70.8% of surgical interventions on the pancreas in children can be performed by laparoscopic access with a conversion rate in 12.5% of cases. \u0000CONCLUSIONS: The choice of surgical intervention in children with pancreatic cysts is determined by the etiology, cyst size, localization, connection with the main pancreatic duct, and degree of involvement of the parenchyma in the tumor process. Most operations on the pancreas may be performed using minimally invasive approaches.","PeriodicalId":437552,"journal":{"name":"Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121150463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. A. Bebenina, O. Mokrushina, M. Levitskaya, Vasily S. Shumikhin, N. Erokhina, Anzhelika E. Agavelyan
{"title":"Long-term treatment results of hydronephrosis in children operated in their first year of life. A systematic review","authors":"A. A. Bebenina, O. Mokrushina, M. Levitskaya, Vasily S. Shumikhin, N. Erokhina, Anzhelika E. Agavelyan","doi":"10.17816/psaic1301","DOIUrl":"https://doi.org/10.17816/psaic1301","url":null,"abstract":"BACKGROUND: Congenital stenosis of the ureterоpelvic junction is the most common cause of hydronephrosis in children. \u0000AIM: This systematic review aimed to search and analyze modern literature from 1998 to 2021 on the treatment and postoperative follow-up of children with severe hydronephrosis in the first year of life and study the long-term results. \u0000MATERIALS AND METHODS: Literary sources were searched in PubMed, Web of Science, Scopus, Google Scholar, and eLibrary databases. The following keywords were used to search for English sources: congenital hydronephrosis, severe hydronephrosis, operative treatment, uretero-pelvic junction obstruction infant, children, neonatal, and infancy. Five full-text articles that meet the criteria were included for analysis. \u0000RESULTS: A total of 355 patients were included in the publications. Antenatal screening was described only in two studies. The average age of children at the time of surgery was five months (one to six months). All the authors noted that due to pyeloplasty in the first year of life, the renal parenchyma exhibited a significant increase in thickness; the indicators in dynamics increased by an average of 1.5 times during the year. The size of the renal pelvis decreased by 50%67%. The data of radioisotope scintigraphy were variable; however, in the long-term period, improvement in renal function was noted in all publications. \u0000CONCLUSIONS: This systematic review shows the long-term results of early pyeloplasty in congenital hydronephrosis in young children. A significant decrease in the pelvis and an increase in the thickness of the parenchyma were observed, both of which are an advantage for the restoration of renal function. However, no single algorithm can predict the recovery of renal parenchyma. An accurate assessment of renal parenchymal function should be confirmed by a prospective, randomized, long-term, follow-up study with a large number of cases.","PeriodicalId":437552,"journal":{"name":"Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128281266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. A. Smirnov, V. V. Rybchenok, A. Alexandrov, P. V. Goncharuk, L. Y. Idris, R. Khagurov, A. Evdokimov, Nataliya A. Knyazeva
{"title":"Results of treatment for the posttraumatic neuropathies of peripheral nerves of the upper limb in children","authors":"A. A. Smirnov, V. V. Rybchenok, A. Alexandrov, P. V. Goncharuk, L. Y. Idris, R. Khagurov, A. Evdokimov, Nataliya A. Knyazeva","doi":"10.17816/psaic1517","DOIUrl":"https://doi.org/10.17816/psaic1517","url":null,"abstract":"BACKGROUND: Peripheral nerve injuries are severe types of injury with potential life-long impairment, which is crucial in the pediatric population. Considering the lack of literature on pediatric nerve lesions, we analyzed the results of treatment for children with injuries of the peripheral nerves of the upper extremities in the Department of Microsurgery of the N.F. Filatov Children's City Clinical Hospital. \u0000AIM: This study aimed to evaluate the results of treatment for children with injuries of the peripheral nerves of the upper limb and to establish the relationship between the recovery of the function of the upper limb and the time elapsed from the moment of injury to surgery. \u0000MATERIALS AND METHODS: From 2017 to 2021, 114 patients with injuries of the peripheral nerves of the upper limb were treated in the Department of Microsurgery. The following data were extracted from the case histories and at the follow-up appointment: age, gender, level of damage, type of surgical intervention, period from the moment of injury to surgical intervention, and postoperative recovery of peripheral nerve functions. For the assessment of the sensory function of the nerves, a discriminatory two-point sensitivity test (Weber Test) and the Grigorovich scale were used. Electromyographic and ultrasound studies were also performed. Subjective feelings were assessed using the QuickDash questionnaire. The digital data were subjected to statistical processing. \u0000RESULTS: Analysis of the results of treatment for children with different periods from the moment of injury to surgery found no differences among the groups up to 14 days and more than 14 days (p 0.05). For further data analysis, the patients were divided into four groups depending on the period from the moment of injury to surgery: 1) up to 3 months, 2) from 3 to 6 months, 3) from 6 to 12 months, and 4) more than 12 months. No differences were found in the results (p 0.05). According to the evaluation of the effect of age on the recovery of peripheral nerve function, better recovery of sensitivity was observed at the age of up to 11 years compared with at the age of more than 11 years (p 0.05). \u0000CONCLUSIONS: Considering the lack of statistically significant differences in the results of treatment for children at various times from the moment of injury to surgery, we can conclude that a period of more than 12 months from the moment of injury to surgery does not influence the achievement of satisfactory results of reconstructive surgical interventions for peripheral nerves in children.","PeriodicalId":437552,"journal":{"name":"Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129400003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. S. Molotov, Maria M. Chernobabova, Saidhasan M. Bataev
{"title":"Use of hydrosurgical technologies in the treatment of adults and children. Review","authors":"R. S. Molotov, Maria M. Chernobabova, Saidhasan M. Bataev","doi":"10.17816/psaic1516","DOIUrl":"https://doi.org/10.17816/psaic1516","url":null,"abstract":"Every year, new medical equipment is introduced to surgeons to improve the techniques of surgical interventions and reduce the risk of postoperative complications. One of these methods is hydrosurgery. \u0000This study aimed to analyze medical literature on the experience of using hydrosurgical units in various branches of modern surgical practice, provide information on their effectiveness, and evaluate their main advantages, disadvantages, and prospects for use in pediatric surgery. \u0000Publication search and information analysis were carried out using the databases PubMed, eLibrary, Web of science, and Cyberleninca. The following search phrases were used: hydrosurgery, water jet devices, hydrosurgery, water jet hydrodissection, HybridKnife, Erbejet, VersaJet, water-jetdevices, and water-jetdebridement. For the literature review, only sources in Russian and English published from 2015 to 2022 were selected. The experience of using hydrosurgical units in adult and pediatric surgical practices was considered. According to the specified search parameters, we analyzed 54 articles, 38 of which were included in the literature review. The remaining 16 articles were excluded due to the small sample of patients and incomplete stages of the study. \u0000RESULTS: The results indicated the significant effectiveness and versatility of hydrosurgical methods. The fixed advantages of their use in the modern practice of a surgeon largely prevailed over their disadvantages, allowing their potential application in surgical interventions of varying degrees of complexity. Hydrosurgical technologies in pediatric practice were used in combustiology, treatment of wounds, skin neoplasms, and destructive pneumonia. \u0000CONCLUSIONS: In conclusion, hydrosurgical methods are one of the effective modern surgical approaches to the treatment of patients with various pathologies. An in-depth study of this method in pediatric surgery is warranted.","PeriodicalId":437552,"journal":{"name":"Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130462780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Pimenova, D. A. Khamzina, Evgeniya M. Mukhametova
{"title":"Perineal groove. Cases report and brief review","authors":"E. Pimenova, D. A. Khamzina, Evgeniya M. Mukhametova","doi":"10.17816/psaic1505","DOIUrl":"https://doi.org/10.17816/psaic1505","url":null,"abstract":"Perineal groove is a congenital anal anomaly. This skin defect appears next to the anal opening, similar to a cleft, and is covered by a mucous membrane. The anomaly often occurs in girls. Grooves can be detected in patients with normally formed anus or as part of an anorectal malformation with a perineal fistula or anal stenosis. Perineal groove is a congenital anal anomaly. \u0000This work aimed to provide information for specialists about this congenital developmental anomaly. In our clinic, five girls were observed and diagnosed with perineal groove quite early in their lives (from one to three months of age). Only one required surgical treatment because she had an anorectal malformation with a perineal fistula. In one case, bougienage of the anus was prescribed because stenosis was detected in a timely manner. For the three girls with a normally formed anus, surgery or other types of treatment were not indicated. In other clinics, either long-term courses of conservative local therapy were prescribed for anal fissure or folds in the anus or a diagnosis of anorectal defect was made with indications for surgery. This study also analyzed current publications on the diagnosis and treatment of congenital perineal sulcus.","PeriodicalId":437552,"journal":{"name":"Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care","volume":"201 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134150440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Rozinov, S. G. Suvorov, V. Petlakh, Oleg S. Gorbachev, N. Erokhina, A. Belyaeva
{"title":"VIII Forum of Pediatric Surgeons of Russia","authors":"V. Rozinov, S. G. Suvorov, V. Petlakh, Oleg S. Gorbachev, N. Erokhina, A. Belyaeva","doi":"10.17816/psaic1527","DOIUrl":"https://doi.org/10.17816/psaic1527","url":null,"abstract":"After almost three years of the pandemic, in November 2022, pediatric surgeons came together in Moscow for the traditional Forum at the Izmailovo Hotel. The program of the plenary session of the forum included the presentation of the annual prize named after S.D. Ternovsky For a great contribution to the development of domestic pediatric surgery, which was awarded to Professor V.A. Novozhilov. Within the framework of the plenary session, a report dedicated to the 100th anniversary of the birth of Girey Alievich Bairov was also presented. The topic of neonatal surgery was actively discussed both in the plenary report of Professor D.A. Morozov Surgery of newborns in the Russian Federation, and in the discussion format of the schools of pediatric surgeons in Moscow and St. Petersburg. Video session How I do it. A workshop was held for the main childrens, which touched upon the unresolved issues of the specialty, in particular the problem of providing surgical care to children by general surgeons. The extensive program of the three days of the forum included symposiums, round tables and master classes on topical issues of pediatric surgery. The forum was attended by 1,706 specialists from 14 countries. The audience of participants has significantly expanded due to remote broadcasting, the duration of which was 43.5 hours. On the final day of the Forum, a traditional competition of research papers for young scientists took place. \u0000The VIII Forum of Pediatric Surgeons of Russia was a large-scale event covering the actual problems of our specialty. Presented reports and discussions showed directions for further scientific development and introduction of advanced medical technologies into practice.","PeriodicalId":437552,"journal":{"name":"Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care","volume":"119 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122470434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. A. Akselrov, E. Dyakonova, S. Karavaeva, O. Karaseva, S. Kovarskiy, Y. Kozlov, S. Minaev, O. Mokrushina, D. Morozov, V. Petlakh, Igor V. Poddoubny, A. Podkamenev, A. Razumovskiy, Y. Sokolov, V. V. Kholostova, N. Tsap
{"title":"Intestinal anastomoses in children: The draft decision of the Russian Symposium of Children surgeons (April 2023)","authors":"M. A. Akselrov, E. Dyakonova, S. Karavaeva, O. Karaseva, S. Kovarskiy, Y. Kozlov, S. Minaev, O. Mokrushina, D. Morozov, V. Petlakh, Igor V. Poddoubny, A. Podkamenev, A. Razumovskiy, Y. Sokolov, V. V. Kholostova, N. Tsap","doi":"10.17816/psaic1526","DOIUrl":"https://doi.org/10.17816/psaic1526","url":null,"abstract":"The Symposium of Pediatric Surgeons of Russia, Intestinal Anastomoses in Children, was conducted in Volgograd on April 26, 2023, with around 180 doctors in attendance. Thirty papers were presented and discussed, and 41 articles were published in the proceedings of the symposium. According to the results of a systemic analysis of a questionnaire poll of major pediatric surgeons in 75 regions of Russia, 4,558 surgeries on intestinal anastomosis formation were performed in 20212022, including 1,735 operations in newborn children (36%); their share in general pediatric surgery was less than 0.6%, and it was more than 18.6% in neonatal surgeons. The number of intestinal anastomoses formed during laparoscopic procedures increased (4.4%). Pediatric surgeons equally often used double-row nodal intestinal sutures (33.3%), single-row continuous sutures (34.6%), and different types of sutures (33.3%). A T-shaped anastomosis was performed in cases of necrotizing enterocolitis where there was a significant difference in the diameters of the intestine's inflow and outflow channels. The clip-and-drop technique was used to treat neonates with multifocal necroses. Interintestinal anastomoses were favored over enterostomies in numerous segmental resections. For duodenal obstruction, duodeno-duodenal, and duodeno-jejunal anastomoses were performed. In children with Crohn's disease and choledochal cysts, most specialists prefer operations with stapling devices. Creating a magnetic interintestinal anastomosis lowers the risk of postoperative complications and facilitates the postoperative period. Clinical observations after laparoscopic surgeries accounted for a significant proportion of complications (66%). Anastomosis failure was three times more common in planned small intestinal in older children than in emergency surgeries (1.2 and 0.4%, respectively). \u0000The modern stage of development of intestinal anastomosis formation techniques in children is characterized by good results, the expansion of indications for intestinal anastomosis in conditions of compromised colon or peritonitis, and the introduction of laparoscopic techniques and mechanical stapling devices with slightly poorer results.","PeriodicalId":437552,"journal":{"name":"Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127452138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Commentary on the article «Debatable problems of classification of modern hematogenous osteomyelitis in childre»","authors":"N. S. Strelkov","doi":"10.17816/psaic1519","DOIUrl":"https://doi.org/10.17816/psaic1519","url":null,"abstract":"Commentary on the article A.S. Safarov, A.M. Sharipov, B.A. Safarov, A.T. Korokhonov entitled Debatable problems of classification of modern hematogenous osteomyelitis in childre published in the Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(2):257-266. (In Russ.) DOI: https://doi.org/10.17816/psaic1290","PeriodicalId":437552,"journal":{"name":"Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126885906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Sokolov, G. Tumanyan, A. Efremenkov, Zh.R. Omarova, O. Y. Koshurnikov, Alaniia A. Gogichaeva
{"title":"Diagnostics and surgical management of periampullary duodenal duplication cysts in children: a report of cases","authors":"Y. Sokolov, G. Tumanyan, A. Efremenkov, Zh.R. Omarova, O. Y. Koshurnikov, Alaniia A. Gogichaeva","doi":"10.17816/psaic1500","DOIUrl":"https://doi.org/10.17816/psaic1500","url":null,"abstract":"BACKGROUND: Obstructive variants of chronic duodenal obstruction may be caused by congenital malformations, such as rare periampullary duodenal duplication cysts. This localization of gastrointestinal duplications is the rarest and is not described in the domestic literature. \u0000AIM: This study aimed to present the experience of the management of periampullary duodenal duplication cysts in children. \u0000CASES REPORT: Seven children with periampullary duodenal duplication cysts underwent surgery between 2007 and 2022. All patients suffered from prolonged abdominal pain, vomiting of food, and bile. Two children had recurrent pancreatitis, and one child underwent repeated operations for high intestinal obstruction and biliary obstruction in other hospitals. An abdominal cyst was suspected in one patient at another hospital, and the child underwent exploratory laparoscopy, but no formation was found. Ultrasound, gastroduodenoscopy, computed tomography, and magnetic resonance imaging were performed on these children. Ultrasound examination showed a peristaltic cystic formation up to 4 cm in diameter with a double wall. Gastroduodenoscopy showed formation in the second portion of the duodenum in the region of the major duodenal papilla. This formation covers the intestinal lumen by two-thirds and up to nearly complete obturation. The relationship between duodenal duplication and the bile and pancreatic ducts was clarified on magnetic resonance cholangiopancreatography: the relationship was suspected in two children. All patients underwent wide transduodenal excision of periampullary duodenal duplication cyst; in four cases, laparoscopic access was used. No intra- and postoperative complications occurred. Histological examination revealed true duplications in all cases. The children were discharged on days 1112. In the follow-up after 3 months and 10 years, no complications were noted. \u0000CONCLUSIONS: Periampullary duodenal duplication cysts can be a cause of chronic duodenal obstruction. Transduodenal excision of periampullary duodenal duplication cysts is the optimal treatment, and this operation can be performed laparoscopically.","PeriodicalId":437552,"journal":{"name":"Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115086088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Predictors of the need for re-evacuation of newborns from secondary level hospitals","authors":"R. Mukhametshin, O. Kovtun, N. S. Davydova","doi":"10.17816/psaic1487","DOIUrl":"https://doi.org/10.17816/psaic1487","url":null,"abstract":"BACKGROUND: The medical evacuation of premature newborns to institutions providing a higher level of medical care results in the reduction of death risk. The use of pediatric intensive care units in level 2 organizations for the hospitalization of newborns can be a potential solution to the lack of neonatal beds in level 3 institutions. \u0000AIM: This study aimed to determine the predictors of the re-evacuation of newborns from level 2 medical organizations to level 3 institutions. \u0000MATERIALS AND METHODS: This observational, cohort, retrospective study included data of 284 cases of the evacuation of newborns from level 1 and 2 medical organizations without a pediatric intensive care unit to level 2 medical organizations with a pediatric intensive care unit. The sample was divided into two groups: the first group included patients who received the necessary therapy in level 2 medical organizations and did not require further evacuation to level 3 (n = 261), and the second group included patients who required further transfer to level 3 (n = 23). Anamnesis data, nosological structure, respiratory support parameters, intensive therapy, and volume of pretransoport activities in the groups were analyzed. Methods of statistical analysis included median, interquartile range, proportion and its 95% CI, Fisher exact test, MannWhitney test, receiver operating characteristic analysis, and odds ratio. \u0000RESULTS: The predictor of the requirement for re-evacuation was birthweight (area under the curve [AUC] 0.658 [0.5220.795]). When only patients on a ventilator were included in the analysis, the saturation oxygenation index (AUC 0.730 [0.5790.863]) and the SpO2/FiO2 ratio (AUC 0.720 [0.5710.869]) have the maximum predictive value. \u0000CONCLUSIONS: Birthweight of 1390 g (AUC 0.658 [0.5220.795], sensitivity 0.348 [0.1530.542], and specificity 0.950 [0.9240.977]) is a predictor of the requirement for further evacuation of newborns from level 2 pediatric and neonatal intensive care units to a level 3 organization. For patients on a ventilator, such predictors included saturation oxygenation index 4.25 (AUC 0.730 [0.5790.863], sensitivity 0.471 [0.2330.708] and specificity 0.928 [0.8880.967]) and SpO2/FiO2 ratio 265.71 (AUC 0.720 [0.5710.869], sensitivity 0.588 [0.3540.822], and specificity 0.837 [0.7810.893]). However, the high negative and low positive predictive values for these parameters do not allow their solitary use when deciding about routing a newborn.","PeriodicalId":437552,"journal":{"name":"Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care","volume":"585 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132591681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}