THE SIGNIFICANCE OF CLINICAL AND LABORATORY SIGNS IN ASSESSING THE EFFECTIVENESS OF NUTRITIONAL SUPPORT FOR CRITICALLY ILL NEWBORNS

Abstract

Introduction. The choice of starting nutritional support in newborns depends on the severity of multiple organ failure and the initial metabolic process in the early neonatal period. The purpose is to study the prognostic value of clinical and laboratory parameters in assessing the metabolic status of newborns in need of nutritional support. Materials and methods. 125 newborns are included in the study. They are divided into 2 groups: 69 children with the somatic disorder symptoms, 55 with surgical pathology. Prognostic assessment of biochemical markers and their relationship with nosological profi le and nutritional corrected types is performed using statistical methods of data processing. Results and сonclusion. In patients with somatic disorders cardiorespiratory hypoxia aff ects the nutritional status in the short term. The tolerance to full enteral nutrition is restored within a week. Surgical trauma is associated with the hypercatabolic syndrome, dysproteinemia and fl uctuations in body weight. The prognostic value of death is determined in groups: in the surgical one with C-reactive protein growth (AUC >0,9, p=0,000), the elevated of blood urea nitrogen after surgery (AUC >0,8, p=0,000) and lactate on the 7th day (AUC=0,989, p=0,000); in newborns with the somatic disorder C-reactive protein growth is valuable in ICU admission and glucose concentration is on the 7th day (AUC=0,88 and AUC=0,94, p=0,000 respectively). For nutritional support, the values of C-reactive protein are relevant in the somatic group. There are actual levels of glucose, blood urea nitrogen, albumin on the fi rst postoperative day. The duration of parenteral nutrition is signifi cantly aff ected by surgical treatment and albumin transfusion (p=0.000), η2=26.4% (ANOVA method). In the choice of nutritional support the personalized approach is important to determine metabolic status.