[Hydrocephaly in newborns with perinatal brain damage of moderate severity].
A prospective examination of 103 newborns with hypoxic damage of the central nervous system of moderate severity was conducted on the 4-7, 10-14 and 21-28 days after birth and included clinical examination, neurosonographic study with dopplerography of great brain arteries and biochemical study of venous blood and urine. Children with ventriculomegalia were treated with diacarb. A control group included 15 newborns without signs of survived hypoxia. Ventriculomegalia was found in 29% of children in the main group and remained till the end of neonatal period in 15%, with moderate and large dilatation in 63,5% and mild dilatation of anterior horns of lateral ventriculars in 36,5%. The markers of development and long remaining ventriculomegalia are specified as follows: the morphofunctional immaturity of the brain (RR=1,7; 95%CI 1,16-2,45), absence of compensatory reduction of resistance index (RI) in anterior brain arteries on 4-7 days of life (RR=3,03; 95%CI 2,11-4,31), metabolic acidosis - the bicarbonate level in the venous blood less than 21 mmol/l (RR=2,9; 95% CI 1,66-5,02), carbanhydrase activation - bicarbonate concentration in the urine less than 5 mmol/mcmol of creatinine on 4-7 days of life (RR=3,81; 95%CI 2,87-5,02). Diacarb in ventriculomegalia should be prescribed only in case of disturbance of the organism compensatory reaction because it causes the significant increase of compensatory reduced RI. The drug has a nephrotoxic effect and causes metabolic acidosis.
Kozlova
E M
EM
Remizova
N V
NV
Khaletskaia
O V
OV
D000086:Acetazolamide / Q000627:therapeutic use*; D001639:Bicarbonates / Q000097:blood / Q000652:urine; D002545:Brain Ischemia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D002552:Cerebral Ventricles / Q000098:blood supply / Q000000981:diagnostic imaging; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003404:Creatinine / Q000097:blood / Q000652:urine; D004232:Diuretics / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D006849:Hydrocephalus / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D007231:Infant, Newborn; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D017585:Ultrasonography, Doppler, Transcranial
D001639:Bicarbonates; D004232:Diuretics; D003404:Creatinine; D000086:Acetazolamide