MARKERS FOR PREDICTING THE DEVELOPMENT OF CRITICAL CONDITION IN CHILDREN WITH RESPIRATORY DISEASES UNDER INTENSIVE THERAPY

Introduction. The clinical course of respiratory diseases is often accompanied with the impairment of the nervous system, it makes up a large proportion in the clinical picture of diseases, and often leads to long-term adverse effects. The purpose of the study is to elaborate the diagnostic algorithm for predicting the course of diseases in children with respiratory pathology during the intensive care based on the thorough study of clinical and anamnestic predictors. Subjects and methodology. The study included 132 children aged from 1 day to 1 year with various pathologies during intensive care. The children were divided into 6 groups: I group included 87 patients with acute respiratory viral infection (ARVI), pneumonia; II group included 21 children with ARVI, stenosis of II-III degree, III group involved 10 children with hypoxic-ischemic encephalopathy. There was a group of children supported with artificial lung ventilation (14), who make up IV group; 20 children died. The control group consisted of 25 healthy children aged under 1 year old. We carried out clinical, bacteriological, immunological examination and statistical processing of findings obtained. Results. When assessing the cases of the clinical course in children up to 1 year, who needed intensive care to mitigate the symptoms of acute respiratory failure of II-III degree, we have found out that except of aggravating factors in the ante-, intra- and postnatal period, there are the number of  pathological change detected by neurosonography, which are of unfavourable predictive value: 29.5% of children had subependymal haemorrhages; 10.3%, of children had intraventricular haemorrhages, 9% of children had periventricular haemorrhages. Infants with acute respiratory failure III degree who needed artificial lung ventilation (50% of them were premature) were born to mothers with a pathologic pregnancy and childbirth. Among children who were in the intensive care unit, the general mortality was 15.2%. The causes of death of newborns included asphyxia (80%), respiratory disorder syndrome III degree (10%), hypoxic-ischemic encephalopathy (10%). In the long-term period, the main cause of death was pneumonia, complicated by acute respiratory failure III degree, brain oedema. Conclusion. Applying of the markers to prevent and reverse the development of infants’ critical condition promotes to the reduction of morbidity, disability and mortality of children.