Osnovnoj problemoj pri gipoksicheskoj ishemicheskoj encefalopatii novorozhdennyh (GIE) yavlyayutsya rannyaya differencial'naya diagnostika, prognozirovanie i klassifikaciya zabolevaniya, ot rezul'tatov kotoryh napryamuyu zavisit dal'nejshij metod terapii, v chastnosti, naznachenie terapevticheskoj gipotermii. Sushchestvuet pryamaya zavisimost' vremeni nachala terapevticheskoj gipotermii i dolgosrochnogo nevrologicheskogo iskhoda: chem ran'she nachata terapevticheskaya gipotermiya, tem luchshe prognoz dlya pacienta. V obzore proanalizirovany poslednie dostizheniya v oblasti sistemnoj biologii, napravlennye na rannyuyu differencial'nuyu diagnostiku GIE v dopolnenie k klinicheskim: primenenie proteomnyh i metabolomnyh biomarkerov, a takzhe vnekletochnyh vezikul, dlya kotoryh ustanovlena svyaz' s tyazhest'yu GIE i prognozom iskhoda. Vyyavlenie selektivnyh markerov povrezhdeniya golovnogo mozga u novorozhdennyh v pervye chasy zhizni zatrudneno iz-za sistemnogo vliyaniya gipoksii na ves' organizm. Osobyj interes predstavlyayut metabolomnye issledovaniya krovi novorozhdennyh s ispol'zovaniem hromato-mass-spektrometrii, pozvolyayushchie analizirovat' sotni metabolitov na nebol'shom kolichestve biologicheskogo obrazca i opredelyat' patterny, sootvetstvuyushchie povrezhdeniyu mozga, chto budet sposobstvovat' bolee tochnoj i svoevremennoj postanovke diagnoza GIE dlya naznacheniya terapevticheskoj gipotermii.

Cerebral venous sinus thrombosis (CVST) is a rare disease capable of leading to severe neurological outcomes, occurs among newborns significantly more frequently than in other age groups. The main risk factors for the development of CVST are gestational or perinatal complications (24%), dehydration (25%), infections of the central nervous system (18%) and thrombophilia (32%). Application of new methods of neurovisualization allows early diagnosis of this pathology. The review discusses main risk factors, clinical manifestations, diagnostic methods and specificities of CVST therapy.

This quideline provides the diagnostic and treatment algorithm for newborns with gestational age over 35 weeks and weighing more than 1800g who has severe asphyxia in birth with the threat of severe or medium-severe hypoxic-ischemic encephalopathy.

This guideline provides the diagnostic and treatment algorithm for newborns with gestational age over 35 weeks and weighing more than 1800g who has severe asphyxia in birth with the threat of severe or medium-severe hypoxic-ischemic encephalopathy.

UNLABELLED:It is common knowledge that arterial hypotension is a one of most prevalent pathology of early neonatal period and it causes severe neurological complications. Purpose of the prospective randomized open study was to assess the efficacy of HES 130/0.4 (6% Voluven) as a start medicine for arterial hypotension in early neonatal period in comparison with normal saline solution (0.9% NaCl).MATERIALS AND METHODS:the study was held from January 2010 to September 2011. Newborns of the ICU with arterial hypotension on the first day of life were included into the study. Acute haemorrhage was an exclusion criterion. Routine monitoring of arterial pressure, heart rate and diuresis was carried out in all newborns. pH, pCO2, pO2 blood glucose, lactate and BE levels were measured before and after the treatment. Echocardiography, examination of regional blood flow in anterior cerebral artery, renal artery and mesenteric artery was held HES 130/0.4 (6% Voluven) and saline solution (0.9% NaCl) were used Parameters of haemostasis, biochemical and haematological analysis monitored after the solutions use. Time of arterial pressure normalization and duration of the treatment positive effect were recorded Episodes of hypotension, amount of cardiotonics per day and per 7 days and duration of cardiotonics administration were recorded as well.RESULTS:6% Voluven infusion both to 0.9% NaCl infusion normalizes the regional circulation. Furthermore it increases the blood pH and diuresis. Lactate level normalization occurred only after 6% Voluven infusion. There was not change of serum sodium level. Liver enzymes, C-protein, prothrombin index were same in both groups of patients. 6% Voluven use in newborns with extremely low birth weight was accompanied with increasing of creatinine level, prolongation of activated partial thromboplastin time and increasing of intraventricular hemorrhage rate. Newborns with weight over 1000 gram did not have these complications. Voluven advantage in comparison with saline solution is a decreasing of cardiotonics administration in patients with weight over 1000 gram.CONCLUSIONS:6% Voluven is more effective than 0.9% NaCl for increasing of cardiac output, myocardial contractile ability and diuresis, normalization of liquid balance and lactate level, decreasing of cardiotonics amount. 6% Voluven can be recommended for arterial hypotension treatment in newborns with weight over 1000 gram both to normal saline solution especially in case of shock.