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Abstract
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.
Methods 52 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 characteristics Palivizumab 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.
Results Efficiency 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.
Conclusions These findings based on our experience of Palivizumab administration in patients with BPD demonstrate perspectives of treatments of the patients with intractable disease.