Cytoenergy and probiotic optimization of the intensive care of gastrointestinal syndrome in new-borns: evaluation of clinical effectiveness
Background. The pathogenesis of gastrointestinal failure in critically ill newborns against the background of the anatomical and functional features in newborns grounds the inclusion of ergodynamic compounds and probiotics in the therapy. The purpose of the work is to evaluate the clinical efficacy of cytoenergetic and probiotic therapy optimization in the intensive care of gastrointestinal failure syndrome in newborns. Materials and methods. The study group consisted of 146 newborns with gastrointestinal failure under conditions of intensive care. The main group (n = 82) included the patients who had additionally prescribed the drug meglumine sodium succinate and probiotic containing Lactobacillus acidophilus (spp. L.gasseri), Bifidobacterium infantis, Enterococcus faecium; the comparison group (n = 64) included the patients receiving traditional therapeutic tactics. Clinical manifestations of gastrointestinal failure, systemic inflammatory response, frequency of use of prokinetics, the condition severity, and survival were evaluated. Results. In contrast to the comparison group, in the main group demonstrated a decrease in the severity of gastrointestinal failure 1.42 times more often, which was registered in 71 % of newborns (χ2 = 6.53; р = 0.011). The need for the appointment of prokinetics decreased 2.2 times, which was necessary in 9 % of patients (χ2 = 4.22; р = 0.04). The grade of the condition severity decreased by 1.06 times (88 % of patients), although there was no statistically significant difference with the comparison group in this parameter (χ2 = 0.73; р = 0.394). Survival increased by 1.11 times, which was 99 % (χ2 = 6.51; р = 0.011). Also, the analysis results demonstrated significant correlation of the severity of the systemic inflammatory response (R = -0.21; p = 0.013), the condition severity (R = -0.18; p = 0.026), the frequency of prokinetics administration (R = -0.17; p = 0.04), survival rate (R = 0.21; p = 0.01) with optimized treatment tactics. Conclusions. In newborns, supplemental administration of meglumine sodium succinate and probiotics in the complex of intensive care can reduce the manifestations of gastrointestinal failure syndrome, reduce the need for prokinetics, influence the severity of the systemic inflammatory response, the severity of the condition and increase survival.