CLINICAL AND INSTRUMENTAL DATA COMPLEX AGGREGATIVE IN FATAL OUTCOME RISK PROGNOSIS IN NEWBORN WITN CONGENITAL HEART DISEASES
Main Article Content
Abstract
Tactical issues of newborn monitoring optimization with congenital heart diseases require a decision.
Objective – a predicative model creation of high fatal outcome risk in newborn with congenital heart disease in neonatal period, a received model approbation in practices.
Materials and methods. Clinical and instrumental data analyzing was carried out in 98 newborn with critical congenital heart diseases on the third day of life. 45 criteria were outlined among all clinical and instrumental data, each of them was a fatal outcome predictor in the present patients category. A predicative model of high fatal outcome risk was created with the aid of «trees classification» statistics method. The present algorithm was approbated in 23 newborn with congenital heart disease.
Results. A combination of fatal outcome risk factors in neonatal period with congenital heart disease was carried out. Hypoxemia with saturation below 79%, the heartbeat rate below 119/min, circulation minute volume more than 720 l/min, stroke output below 5,3 ml, myocardial mass below 7,1 gr or above 13,7 gr. Created predicative model had a diagnostic effectiveness – 92,9%. Diagnostic effectiveness was 87,0% during the approbation and a strong connection between risk factors and an outcome was shown as well.
Conclusion. Arterial oxygen saturation level, heartbeat rate, echocardiographic data: stroke output, left ventricular myocardial mass, circulation minute volume should be included inti the predicative algorithm of a negative outcome in patients with critical congenital heart disease.Keywords
Article Details
Information about financing and conflict of interests
The authors declare that they have no apparent or potential conflicts of interest related to the publication of this article.
This work is licensed under a Creative Commons Attribution 4.0 License.
How to Cite
References
Klimenko TM, Sorokolat UV, Karapetyan OU. Results and problems of newborn monitoring with congenital heart disease. Perinatology and pediatrics. 2013; (3): 85. Russian (Клименко Т.М., Сороколат Ю.В., Карапетян О.Ю. Результаты и проблемы ведения новорожденных с врожденными пороками сердца //Перинатология и педиатрия. 2013. № 3. С. 85.)
Sharykin AS. Congenital heart disease: fetus and newborn problems. Consilium medicum. Pediatrics (attachment). 2012; (3): 54-58. Russian (Шарыкин А.С. Врожденные пороки сердца: проблемы плода и новорожденного ребенка //Consilium Medicum. Педиатрия (Прил.). 2012. № 3. С. 54-58.)
Wright J, Kohn M, Niermeyer S, Rausch CM. Feasibility of critical congenital heart disease newborn screening at moderate altitude. Pediatrics. 2014; 133: 561-569
Tcoi EG, Kurenkova OV, Igisheva LN, Kireeva OV, Tsigelnikova LV. Clinic and diagnostics of congenital heart diseases with complicated course newborn. Mother and Baby in Kuzbass. 2014; (3): 16-22. Russian (Цой Е.Г., Куренкова О.В., Игишева Л.Н., Киреева О.В., Цигельникова Л.В. Клиника и диагностика врожденных пороков сердца с осложненным течением у новорожденных //Мать и Дитя в Кузбассе. 2014. № 3. С. 16-22.)
Jegatheesan P, Song D, Angell C et al. Oxygen saturation nomogram in newborns screened for critical congenital heart disease. Pediatrics. 2013; 131: 1803-1810
Shkolnikova MA, Bokeria EL, Degtyarova EA et al. Neonatal screening aimed to congenital heart disease early identification: methodological materials. М., 2012; 36 p. Russian (Школьникова М.А., Бокерия Е.Л., Дегтярева Е.А. и др. Неонатальный скрининг с целью раннего выявления критических врожденных пороков сердца: методические рекомендации. М., 2012. 36 с.)
Peterson C, Grosse SD, Oster ME et al. Cost-effectiveness of routine screening for critical congenital heart disease in US newborns. Pediatrics. 2013; 132: 595-603
Senatorova AS, Gonchar MA, Boychenco AD. Newborn diagnostic and monitoring modern principals with congenital heart disease. Perinatology and Pediatrics. 2013; (1): 123. Russian (Сенаторова А.С., Гончарь М.А., Бойченко А.Д. Современные принципы диагностики и тактика ведения новорожденных с врожденными пороками сердца //Перинатология и педиатрия. 2013. № 1. С. 123.)
Martin GR, Beekman RH, Mikula EB et al. Implementing recommended screening for critical congenital heart disease. Pediatrics. 2013; 132: 185-192
Rudenko NN. Treatment tactic in critical congenital heart disease in infants. Children Surgery. 2012; (3): 12-18. Russian (Руденко Н.Н. Лечебная тактика при критических врождённых пороках сердца у младенцев //Хирургия детского возраста. 2012. № 3. С. 12-18.)
Chereshnev VA, Gusev EU. Immunological and pathophysiological systemic inflammation mechanisms. Medical Immunology. 2012; 14 (1-2): 9-20. Russian (Черешнев В.А., Гусев Е.Ю. Иммунологические и патофизиологические механизмы системного воспаления //Медицинская иммунология. 2012. Т. 14, № 1-2. С. 9-20.)
Khalafyan AA. Modern statistical methods of medical research. M., 2014. 320 p. Russian (Халафян А.А. Современные статистические методы медицинских исследований. М., 2014. 320 с.)