| Abstract | Cilj istraživanja: Cilj istraživanja bio je utvrditi zastupljenost dijagnoza među kasnom nedonoščadi. Ispitanici i metode: Istraživanje je provedeno u Zavodu za intenzivnu pedijatriju s postintenzivnom skrbi, Klinike za dječje bolesti, Kliničkog bolničkog centra Split, u razdoblju od deset godina (od 1. siječnja 2010. do 31. prosinca 2019.), na 86 kasne nedonoščadi. Prikazali smo spol, duljinu hospitalizacije, perinatalnu anamnezu, način porođaja, porođaj po redu, porođajnu masu i dužinu, Apgar zbroj, učestalost pozitvnih hemokultura i apsirata traheje, načine ventilacije, korištenje surfaktanta, iNO, aminofilina i kofein citrata, antibiotika i antimikotika, primjenu postupaka reanimacije, ishod liječenja te učestalost dijagnoza u kasne nedonoščadi. Rezultati: Od 86 kasne nedonoščadi primljene u Zavod, 69% bilo je muškog spola. Transportom „k sebi“ primljeno je 12 ispitanika. Najčešća perinatalna anamneza bila je prijevremeni porod. Carskim rezom rođeno je 60,5% ispitanika, a prvorotkinja je bilo 42%. Zadovoljavajući Apgar zbroj imalo je 79% kasne nedonoščadi. Od uzetih hemokultura, 31,6% bilo je pozitivnih, a pozitivnih aspirata traheje 22,8%. Kao najčešći oblik respiratorne potpore, u 79% slučajeva korištena je SIMV. Surfaktant je primijenjen u 39,5%, iNO u 3,5%, aminofilin u 12,8%, a kofein citrat u 8,1% kasne nedonoščadi. U najviše slučajeva, 44%, primjenjena je kombinacija antibiotika prvog reda i antibiotika rezerve. Antimikotici primjenjeni su u 29 kasne nedonoščadi. Kao vodeća dijagnoza na prvom mjestu nalazi se hiperbilirubinemija, prisutna kod 39,5%, a zatim RDS kod 33,7% kasne nedonoščadi. Reanimirano je devetero ispitanika. Ukupno preživljenje iznosilo je 87,2%. Zaključci: Kasna nedonoščad populacija je nedonoščadi s rizikom raznih novorođenačkih komplikacija i poteškoća u razvoju, pa bi stoga trebalo pažljivo procijeniti potrebu dovršetka trudnoće prije navršenog termina. Kasna nedonoščad najčešće nije rutinski praćena nakon porođaja. Preporuka je da se poveća nadzor nad ovom skupinom novorođenčadi, kako bi se na vrijeme otkrili lošiji zdravstveni i razvojni ishodi, te započelo s ranim intervencijama. |
| Abstract (english) | Objectives: The main objective was to determine incidence of diagnoses in late preterm infants. Patients and methods: The study was conducted in the PICU, Department of Pediatrics, University Hospital of Split, in period of ten years (from January 1st 2010 to December 31st 2019), on 86 late preterm infants. Sex, length of stay, perinatal anamnesis, way of delivery, parity, birth weight and lenght, Apgar score, incidence of positive blood cultures and tracheal aspirates, type of ventilation, use of surfactant, iNO, aminophylline and caffeine citrate, antibiotic and antifungal drug use, resuscitation, incidence of diagnoses were studied as well as the final outcome. Results: Out of 86 late preterm infants studied, 69% were male. Twelve of them were twoway transported to the PICU. The most common perinatal anamnesis was premature birth. 60,5% of the late preterm infants were born by caesarean section and 42% were firstchildbirth. Normal Apgar score had 79% of the late preterm infants. 31,6% of the taken blood cultures were positive, as well as 22,8% of the tracheal aspirates. Late preterm infants were mostly ventilated by SIMV. Surfactant was used in 39,5%, iNO in 3,5%, aminophylline in 12,8% and caffeine citrate in 8,1% of late preterm infants. Combined antibiotic therapy of common antibiotics and antibiotics for treating multi-drug resistent bacteria was the most common type of antimicrobial therapy, in 44% patients. Antifungal therapy was used in 29 late preterm infants. Leading diagnosis was hyperbilirubinemia, in 39,5% of infants studied. RDS was the second most common diagnosis, in 33,7% late preterm infants. Nine infants were resuscitated. Total survival rate was 87,2%. Conclusions: Late preterm infants are population at risk of various newborn complications and developmental difficulties, so the need for delivery before term should be carefully evaluated. Late preterm infants usually are not routinely followed up after birth. It is recommended that this group of newborns should be carefully monitored, with the purpose that poor health and development outcomes will be discovered on time, so early intervention programmes can begin. |
