inovmedИнновационная медицина КубаниInnovative Medicine of Kuban2541-9897Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 110.35401/2500-0268-2022-25-1-83-89inovmed-511Research ArticleОБЗОРЫREVIEWSПрогнозирование синдрома полиорганной недостаточности у новорожденных детейMultiple organ dysfunction syndrome prediction in newborn childrenhttps://orcid.org/0000-0001-7522-9094ГоломидовА. В.GolomidovA. V.

Голомидов Александр Владимирович, к. м. н., заместитель главного врача по педиатрии, врач – анестезиолог-реаниматолог отделения анестезиологии и реанимации № 2

650066, Кемерово, Октябрьский пр., 22

Alexander V. Golomidov, Cand. Sci. (Med.), Deputy Chief Physician for Pediatrics, Anesthesiologist, Department of Anesthesiology and Resuscitation no. 2

Oktyabrsky ave., 22, Kemerovo, 650066

golomidov.oritn@yandex.ruhttps://orcid.org/0000-0001-8370-3083ГригорьевЕ. В.GrigorievE. V.

Григорьев Евгений Валерьевич, профессор РАН, д. м. н., заместитель директора по научной и лечебной работе

Кемерово 

Evgeny V. Grigoriev, Professor of the Russian Academy of Sciences, Dr. Sci. (Med.), Deputy Director for Scientific and Medical Work

Kemerovo

https://orcid.org/0000-0002-3269-9018МозесВ. Г.MosesV. G.

Мозес Вадим Гельевич, д. м. н., профессор кафедры акушерства и гинекологии имени Г.А. Ушаковой

Кемерово  

Vadim G. Moses, Dr. Sci. (Med.), Professor of the Department of Obstetrics and Gynecology named after G.A. Ushakova

Kemerovo

https://orcid.org/0000-0003-2906-6217МозесК. Б.MosesK. B.

Мозес Кира Борисовна, областной специалист

Кемерово 

Kira B. Moses, Regional specialist

Kemerovo

Кузбасская областная клиническая больница им. С.В. БеляеваРоссияKuzbass Regional Clinical Hospital named after S.V. BelyaevRussian FederationНаучно-исследовательский институт комплексных проблем сердечно-сосудистых заболеванийРоссияResearch Institute for Complex Issues of Cardiovascular DiseasesRussian FederationКемеровский государственный медицинский университетРоссияKemerovo State Medical UniversityRussian Federation202230032022018389Copyright © Голомидов А.В., Григорьев Е.В., Мозес В.Г., Мозес К.Б., 20222022Голомидов А.В., Григорьев Е.В., Мозес В.Г., Мозес К.Б.Golomidov A.V., Grigoriev E.V., Moses V.G., Moses K.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.innovmedkub.ru/jour/article/view/511

Существуют несколько направлений прогнозирования синдрома полиорганной недостаточности (СПОН), но почти все они плохо апробированы в неонатологии. Данный обзор литературы представлен для обозначения проблемы объективизации тяжести состояния новорожденных и возможности прогнозирования развития у них СПОН.

Шкалы оценки тяжести СПОН у детей, находящихся в критическом состоянии, разработаны и используются с конца прошлого века, однако их валидация в группе новорожденных сталкивается с определенными трудностями. Прогностические нозоспецифические шкалы: калькулятор NICHD (National Institute of Child Health and Human Development), CRIB II (индекс клинического риска для детей раннего возраста), SNAPPE-II (перинатальная шкала острого состояния новорожденного-II) применяются в неонатологии, однако сравнение их между собой у данной категории пациентов не проводилось.

Теоретические и практические вопросы ближайшей и отдаленной предикции наступления СПОН и его исходов у новорожденных являются перспективным направлением неонатологии, так как позволяют предупредить врача о надвигающейся катастрофе и открывают «окно возможности» для своевременной коррекции лечебной тактики и предупреждения осложнений. Получение различных фенотипов критического состояния и прогнозирование их исходов у детей может обладать хорошим прогностическим потенциалом, однако у новорожденных такие исследования не проводились. Перспективным направлением в предикции СПОН является определение биомаркеров воспаления, среди которых хороший потенциал имеют эндокан, кластер дифференцировки 64, кластер молекулы дифференцировки 11b, «белок панкреатических камней» (PSP), растворимая молекула межклеточной адгезии-1 (sICAM-1), програнулин, неоптерин, резистин (FIZZ3, пресепсин (ПСП), но их эффективность в неонатологии еще предстоит исследовать.

Таким образом, прогнозирование этой тяжелой стресс-реакции у детей и новорожденных остается пока не решенной проблемой. В то же время сегодня активно развиваются несколько перспективных научных направлений, которые возможно приведут к увеличению возможностей в прогнозировании СПОН.

There are several directions for predicting multiple organ dysfunction syndrome (MODS), but almost all of them are poorly tested in neonatology. This review is presented to indicate the problem of the condition severity objectification of newborns and the possibility of predicting the development of MODS. Scales for assessing the severity of MODS in critically ill children have been developed and used since the end of the last century, but their validation in the newborns faces certain difficulties. Prognostic nosospecific scales: NICHD (National Institute of Child Health and Human Development) calculator, CRIB II (Clinical Risk Index for Babies), SNAPPE-II (Score for Neonatal Acute Physiology with Perinatal Extension II) are used in neonatology, however their comparison in this category of patients has not been carried out.

Theoretical and practical issues of the short-term and long-term prediction of the MODS onset and its outcomes in newborns is a promising area of neonatology, since it allows a doctor to be warned about an impending catastrophe and opens a “window of opportunity” for timely correction of treatment tactics and complications prevention. Obtaining different phenotypes of critical illness and predicting their outcomes in children may have good predictive potential, but such studies have not been conducted in newborns. A promising direction in predicting MODS is the identification of biomarkers of inflammation, among which endocan, cluster of differentiation 64, cluster of differentiation molecules 11b, “pancreatic stone protein” (PSP), soluble intercellular adhesionmolecule-1 (sICAM-1), progranulin, neopterin, resistin (FIZZ3, presepsin (PSP)) carry a good potential, but their effectiveness in neonatology is still to be investigated.

Thus, the prediction of MODS in children and newborns remains an unresolved problem. At the same time, several promising scientific directions are actively being developed today, which may lead to a significant breakthrough in predicting MODS in neonatology.

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The authors declare that there are no conflicts of interest present.