Влияние цитофлавина на эффективность интенсивной терапии новорожденных с некротизирующим энтероколитом

Abstract

Postoperative treatment of necrotizing enterocolitis (NEC) in newborns is a challenging problem in pediatric surgery due to high mortality rate among these patients. It is extremely important to search for novel treatments that will not only reduce the death rate, but also improve patients' quality of life. Objective. To improve the outcomes of newborns with NEC in the early postoperative period using cytoflavin, a metabolic antihypoxant/antioxidant. Patients and methods. This study included 77 newborns with NEC operated on in the Department of Neonatal Surgery between 2018 and 2021. All study participants were divided into two groups according to their treatment in the postoperative period. Group 1 (experimental) included 41 NEC patients (53.2%), whereas group 2 (control) included 36 NEC patients (46.8%). The sequential organ failure assessment (SOFA) scale adjusted for neonates was used to evaluate patients' condition. Results. Participants from the experimental group stayed in the intensive care unit for 7.46 ± 1.8 days on average. The maximum SOFA score was 12 and lasted for 3 days in 14 infants (34.1%). Twenty-eight patients had lung ventilation for a mean time of 36.3 ± 4.9 h. Newborns from the control group stayed in the intensive care unit for 10.7 ± 1.2 days on average. Seventeen patients (47.2%) had the maximum SOFA score of 12 for 3 days. The mean duration of lung ventilation was 58.7 ± 4.8 h. Recovery of intestinal transit by 72 h postoperatively was observed in 8 patients from Group 1 and 2 patients from Group 2 (the difference was significant p < 0.05). Conclusion. Hypoxic intestinal damage plays a significant role in NEC development; therefore, metabolic therapy in newborns with NEC ensures a rapid positive effect and faster improvement. Early administration of metabolic therapy with cytoflavin in newborns with NEC reduces the incidence and severity of complications and prevents the progression of multiple organ failure. Key words: necrotizing enterocolitis, postoperative period, cytoflavin