Oct 6, 2021
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Premature babies. New life prediction algorithm

About 12.9 million babies are born prematurely every year. Of these, about a million die within a month after birth due to complications.

In order to take timely measures, neonatologists and pediatric cardiac surgeons need to promptly diagnose diseases. Scientists of the Perm Polytechnic University, P.G. Academician E.A. Wagner and the Federal Center for Cardiovascular Surgery. S.G. Sukhanov developed a diagnostic algorithm based on the methods of computational mathematics, which will identify pathologies of the cardiovascular system in very premature infants and predict their development.

The scientists published the results of the study in the Journal of Clinical Medicine, which is included in the 1st quartile.

The development was implemented with the support of the Russian Foundation for Basic Research in cooperation with the Perm REC of the world level “Rational Subsoil Use”.

– Premature birth is the cause of almost half of all newborn deaths in the world and the second leading cause of death of children under 5 years of age. The peculiarity of the state of health of premature babies is that their organs and systems are not prepared for extrauterine conditions of life. An important problem is a functioning ductus arteriosus, which indicates the immaturity of the cardiovascular system. In this case, a large volume of blood is discharged through the vessel, and this affects the health of the newborn, ”says Aleksey Kuchumov, Associate Professor of the Department of Computational Mathematics, Mechanics and Biomechanics of the Perm Polytechnic Institute, Candidate of Physical and Mathematical Sciences.

By the 4th day of life in newborns weighing 1.5-2 kg, the duct is closed in 93% of cases. Premature babies weighing less than 1.2 kg have this disease in 85% of cases. It can lead to consequences such as damage to the heart, lungs, brain, eyes, intestines and kidneys. An “open” ductus arteriosus increases severe morbidity and mortality by 3 times. With increasing age of the child, drug treatment becomes less effective, in this case, surgery is performed. Therefore, it is extremely important to quickly diagnose the disease: according to scientists, if treatment is carried out on the first day after birth, it is possible to achieve closure of the duct in 85% of patients.

– Now, echocardiography with color Doppler sonography is used to detect the disease, but the diagnosis is not always possible in a timely manner. In our opinion, it is important to identify additional “signals” of the disease. These include the level of natriuretic peptide, an indicator of heart failure. This test is 10 times cheaper than echocardiography and is faster, – explains the surgeon of the Federal Center for Cardiovascular Surgery named after V.I. S.G. Sukhanova, Candidate of Medical Sciences Artem Porodikov.

Developers from the Perm Polytechnic University and their colleagues have created a unified algorithm for diagnosing a functioning ductus arteriosus for the first time. It is based on a summary of risk factors, echocardiographic findings, and natriuretic peptide levels. The development was implemented as a software product.

– Our research includes the analysis of 40 clinical, laboratory, instrumental and anamnestic factors of the condition of a child with congenital heart disease. We identified three factors that affect the development of pathology of the cardiovascular system: the level of natriuretic peptide, indicators for assessing the health status of a newborn at the 5th minute of life, and a scale for assessing the severity of his respiratory disorders. The software product will allow you to quickly and accurately predict how the disease will develop. This will help practicing doctors take the necessary measures in time, – explains the associate professor of the Department of Pediatric Infectious Diseases of P.G. E.A. Wagner, Candidate of Medical Sciences Anna Permyakova.

Dmitry Stepnov

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