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THE ROLE OF RISK OF RENAL FAILURE, INJURY TO THE KIDNEY, FAILURE OF KIDNEY FUNCTION, LOSS OF KIDNEY FUNCTION AND ENDSTAGE RENAL FAILURE (RIFLE) CLASSIFICATION IN IDENTIFICATION AND PREDICTION SEVERITY OF THE KIDNEY INJURY IN NEWBORNS
(SHMSHM / AAMD, 2021)
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Olivera Jordanova
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Elizabeta Shuperliska
Objective: Acute kidney injury is a serious condition with various clinical manifestations ranging from minimal kidneys disordsers to kidney injury requiring substitution therapy. Because of need of timely diagnosis of kidney injury, RIFLE classification could be used. The aim of the study was to determine the role of RIFLE classification in detecting and follow up the progression of kidney injury in newborns. Methods: This study was realized at University Clinic of Pediatrics in Skopje from period of two years. It was analyzed the medical records of 80 newborns (40 with kidney injury and 40 without kidney injury) treated in intensive care unit. The severity of the disease was determined by RIFLE classification. Results: During the study period 6.25% of newborns have developed acute kidney injury acording standard clasification. Most of the newborns analyzed in the study were male (66 and 59%) and term (67% and 61%). RIFLE classification was applied in this study. We reported “risk” in 32%, “injury” in 57% and “failure” in 11% of newborns with AKI. Of these, 69% showed progression to “injury “and 15% to “failure”. In 17% of newborns with verified “injury” the condition progressed to “failure”. Conclusion: By using RIFLE classification we could not only identify kidney injury, but also detected the progression of the disease. Hence the significance of this classification as a solid tool in the diagnosis and follow-up of kidney injury in newborns.
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RELATIONSHIP OF SERUM PROCALCITONIN LEVELS AND C-REACTIVE PROTEIN LEVELS IN NEWBORNS WITH SEPSIS IN DIFFERENT TYPES OF RESPIRATORY SUPPORT IN INTENSIVE CARE UNIT
(Institute of Public Health of the Republic of North Macedonia, 2021)
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Elizabeta Shuperliska
Sepsis in newborns with RDSy and asphyxia is essential; it is a life-threatening condition and still represents an important cause of mortality and morbidity. The aim of this study was to evaluate the predictive values of procalcitonin (PCT) as an early diagnostic and prognostic biochemical marker for sepsis in newborns with RDS and asphyxia. Material and methods: The study was designed as prospective and we examined 110 newborns with proven sepsis admitted in the Intensive Care Unit at the University Clinic of Pediatrics – Skopje in the period between December 2018 and Јanuary 2021. Procalcitonin levels were measured by using the immunoassay system Vidas based on the ELFA principles. The newborns with proven sepsis were divided into two groups. The first group comprised 55 newborns with RDS and proven sepsis and the second group included 55 newborns with asphyxia and proven sepsis. The statistical analysis confirmed significantly different values of PCT in the analyzed time period in first group of newborns with RDS and proven sepsis, p<0.001. The highest average values (40.37±53.79) were measured on admission with a high level of peak compared to the second group of newborns with asphyxia and proven sepsis. The statistical analysis confirmed significantly different values of PCT in the analyzed time period in the first group of newborns with RDS and proven sepsis with mechanical ventilation (MV) and bubble continuous positive airway pressure (BCPAP) compared to the second group of newborns with asphyxia and proven sepsis, p<0.001. PCT is a promising sepsis marker in newborns with RDSy, capable of complementing clinical signs and routine laboratory parameters suggestive of severe infection at the time of ICU admission.
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EARLY DIAGNOSTIC OF SEPSIS IN NEWBORNS WITH RESPIRATORY DISTRESS SYNDROME
(SHMSHM / AAMD, 2020)
Elizabeta Shuperliska
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Avdi Murtezani
Objective: Early diagnosis of sepsis in newborns with RDS is essential for life-threatening condition, for reducing severe sepsis and septic shock in the Intensive care Unit at the University Children’s Hospital in Skopje.Methods: In this prospective study, we included 100 (M:F=59:41) newborns with Respiratory distress syndrome (RDS) suspected for sepsis admitted in the Intensive Care Unit in period of December 2019 till 31 May 2020 y. Procalcitonin levels were measured by using a immunoassay system Vidas based on the ELFA principles. Results: The newborns with RDS suspected for sepsis have been divided into two groups The first group included 50 newborns with RDS and positive blood culture and the second group included 50 newborns with RDS and negative blood culture. Тhe average gestational age of the newborn with RDS and positive blood culture was 36,01± 3,1 weeks and the newborn with RDS and negative blood culture 36,26± 3,2 weeks. Preterm newborns in both groups dominated (64,2% and 58,2%). Тhe average birth weight of the newborn with RDS and positive blood culture was 2490,5 ±791,6 grams, and the newborn with RDS and negative blood culture was 2690,2±788,5grams. There is statistically significant difference in average PCT between the two groups overtime (p<0.05). There is statistically significant difference in average PCT between the two groups overtime procedure (MV , BCPAP, OXYGEN MASK) (p<0.05).Conclusions: PCT is promising sepsis markers in newborns with RDS, capable of complementing clinical signs and routine lab parameters suggestive of severe infection at the time of ICU admission

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