Vol 10, No 2 (2020)


VI forum of children's surgeons of Russia with international participation

Gorbachyov O.S.


Information about the upcoming forum pediatric surgeons Russia, which will take place 22–24 October 2020.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2020;10(2):247-248
pages 247-248 views


Jubilee Vadim G. Geldt

Rozinov V.М.


A brief description of the professional way of one of the leading figures of pediatric surgery in Russia, a remarkable scientist and teacher Vadim Georgievich Geldt, who is 80 years old.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2020;10(2):249-250
pages 249-250 views

In memory of Sheraly R. Sultonov

Petlakh V.I.


Information about the sudden death from Сovid-19, the head of the Department of Pediatric Surgery, Sherali R. Sultonov, the Republic of Tajikistan.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2020;10(2):253-254
pages 253-254 views

Obituary. Vladimir A. Fokin

Rozinov V.М.


Information about the activities of Vladimir A. Fokin, who made a huge contribution to the integration of Russian traumatologists and orthopedists into the world professional community and the introduction of modern technologies of osteosynthesis into domestic medicine.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2020;10(2):255-256
pages 255-256 views

Original Study Articles

Comparative analysis of the dynamics of the duration of the surgery and hematological indicators of blood loss after osteotomy of the ilium and acetabuloplasty in treatment of children with spina bifida

Ivanov S.V., Kenis V.M.


Introduction. Spina bifida is a severe malformation of the spine and spinal cord. Pathology of the hip joint in children with spina bifida has always been one of the most challenging pediatric orthopedic problems.

Purpose of the study. The aim of this study is to perform a comparative analysis of the duration of operations and hematological indicators of blood loss after performing osteotomy of the ilium and acetabuloplasty to treat children with herniated disc consequences in the presence of hip subluxation and dislocation. It also seeks to determine the safest surgical intervention.

Materials and methods. We observed and treated 60 patients aged 3–8 years with spina bifida with subluxation and dislocation of the hip. Patients were subdivided into two groups of 30 patients each, differing in the technique of performing the intervention on the pelvic component of the joint. The first group is represented by patients who underwent osteotomy of the ilium (52 joints) aimed to stabilize the hip joint. The second group comprised children who underwent acetabuloplasty (55 joints), another variant of intervention on the pelvic component of the joint.

Results. As our study shows, performing osteotomy of the ilium required significantly more time than acetabuloplasty (p = 0.0088 (p < 0.05)). In addition, performing osteotomy of the ilium was accompanied by a more pronounced decrease in the level of both hemoglobin and the number of blood erythrocytes than when performing acetabuloplasty.

Conclusion. Our study demonstrates that osteotomy of the ilium requires more time for its implementation. It is accompanied by a more pronounced decrease in hemoglobin and blood erythrocytes than acetabuloplasty. Therefore, we can conclude that acetabuloplasty is preferable in cases where the expected clinical result and the required degree of correction are comparable.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2020;10(2):137-143
pages 137-143 views

Acute period of polytrauma in children in the light of discriminant analysis

Bakovsky V.B., Golovkin S.I., Kukharova T.V., Utkin V.A., Chalaya E.N., Shabaldin N.A.


Introduction. The treatment of polytrauma in children requires identifying the signs that characterize the severity of the acute period and quantifying the priorities of the parameters. Collectively, these reflect the direction of drift of the leading pathophysiological manifestations at each stage of the patient withdrawal program from a state of severe shock.

Purpose. This study uses discriminant analysis to clarify the tactics of children with polytrauma in the first days of overcoming its consequences. It is based on the pathogenetically sound idea that each of the observed parameter’s role, together in the form of a vector, reflects injury severity and the child’s prognosis.

Materials and methods. This analysis included 45 children (34 boys and 11 girls) with polytrauma aged from 2.5 to 17 years and hospitalized in Kemerovo’s intensive care unit. Two groups were analyzed: the survivors and those who were deceased. Both were dominated by severe traumatic brain injury (PMT). The injury severity score (ISS) scale was used for clinical assessment of injury severity.

Results. Combined with objectively obtained data on the structure of polytrauma in the direction of drift, a successful outcome is defined as a whole. It borders on the “day to day” priorities, potassium, PH, white blood count, and hematocrit. Also, the vector orientation pattern was observed to increase organ failure. This progressive decline occurred despite timely surgical intervention to stop internal bleeding, very active efforts to compensate for hypovolemia, acidosis, and the use of adequate means of detoxification. The deterioration in the child's condition manifests itself by increased potassium losses against the background of almost no reaction from leukocytes.

Conclusions. The application of discriminant analysis enables the better revelation of the peculiarities of a polytrauma’s multidimensional dynamics in children in the first few days of resuscitation. It also permits the numerical expression of the priorities of individual parameters that describe their state, and by the severity and individual patient response in real-time to optimize treatment.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2020;10(2):145-156
pages 145-156 views

Video-assisted isolated percutaneous hernia sac suturing in children with inguinal hernia (VIPS)

Pavlushin P.M., Gramzin A.V., Tratonin A.A., Krivosheenko N.V., Koinov Y.Y., Chikinev Y.V.


Background. Inguinal hernias in children are a common problem. They occur in 5–20 cases of 1000 newborns, with the prevalence in males of about 10 times. Therefore, they present a very important problem in pediatric surgery.

Materials and methods. This prospective study was performed from 2019 to 2020 and included 30 patients with diagnosed inguinal hernias. Video-assisted percutaneous hernia sac ligation was performed in all patients.

Results. The mean operating time was 10.3 ± 2.7 min in patients with unilateral inguinal hernias and 14.7 ± 1.6 min in patients with the bilateral variant. No complications or recurrences were observed during the six-month follow-up period. In one case, an additional 3 mm port setting was performed in an eight-month-old child. The main reason for doing this was the fibrous transformation of the parietal peritoneum because of the existence of incarcerations in the anamnesis.

Conclusion. This technique garners all the advantages of a minimally invasive surgical treatment of inguinal hernias using the Tuohy needle. However, the conductor application allows us to create the same approach using a Touhy needle. This means that we can perform an isolated hernia sac ligation without getting under the preperitoneal tissue ligature, parts of the internal oblique and transverse muscles, aponeurosis of the external oblique muscle, and subcutaneous fat. This presented video-assisted percutaneous hernia sac ligation method seems like a potential minimally invasive way to treat inguinal hernias in children.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2020;10(2):157-164
pages 157-164 views

The effectiveness of volume guarantee ventilation in newborns

Ziganshin I.M., Bayalieva A.Z., Babintseva A.A., Shaimardanova G.R.


Background. An important goal of treating respiratory disorders in newborns during the first stage of perinatal care is effective and safe pulmonary ventilation, enabling the administration of surfactant therapy, reducing alveolar dead space, and providing adequate gas exchange.

Objective. The aim of this study is to improve the quality of newborns’ respiratory therapy using double pressure and volume control at the first stage of perinatal care.

Materials and methods. The study involved newborns from week 27 to week 42 gestation with respiratory failure requiring invasive pulmonary ventilation. The ventilation mode was evaluated with pressure control and volume guarantee option compared with routine pressure ventilation. For the comparative characteristic of the compared ventilation methods, we used targets, such as the duration of artificial pulmonary ventilation, reduction of FiO2, dynamics of venous blood lactate, peak and average pressure in the respiratory tract, dynamics of lung compliance, and the development of complications.

Results and conclusions. Given the heterogeneity of lung damage in newborns, the use of the guaranteed volume option reduced the duration of mechanical ventilation, the development frequency of IVH, and the frequency of surfactant use.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2020;10(2):165-172
pages 165-172 views

Influence of general anesthesia for tonsillotomy and adenotomy to cognitive functions in children

Zolotareva L.S., Paponov O.N., Stepanenko S.M., Silina E.V., Adler A.V.


Background. Surgery under general anesthesia can affect the patient’s neurocognitive outcome. This problem is of particular relevance in pediatric surgical practice.

Goal. The aim of this study is to determine the spectrum of clinical manifestations and the frequency of cognitive dysfunction symptom development in children after adenotomy and/or tonsillotomy performed under general anesthesia.

Methods. This prospective study included 30 children aged 3– 7 years (average age 4.9 ± 1.3 years) who underwent adenotomy and/or tonsillotomy under general, combined, balanced anesthesia. In the preoperative period and a day after the operation, neuropsychological testing was performed: The Raven test, mechanical and associative memory test, Mini-Mental State Examination (MMSE) scale adapted for children from 3 years old, and the Bourdon test. A 20% decrease in function compared with the initial level was considered clinically significant.

Results. One day after surgery, 10% of patients had a clinically significant decrease in attention productivity, 10% had a decrease in attention accuracy, 13.3% had a decrease in attention index, and 16.7% had a decrease in overall productivity and the attention index according to the Bourdon test. Also, 13.3% showed a decrease in attention, 30% had a decrease in memory on the MMSE scale, 20% showed a decrease in mechanical memory, and 10% had a decrease in test results on the Raven test.

Conclusion. Conducting even minor surgical interventions with general anesthesia leads to an impairment of various cognitive functions in 10%–30% of children aged 3 to 7 years.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2020;10(2):173-182
pages 173-182 views


Errors and сomplications in the treatment of children with anorectal malformations

Pimenova E.S., Tarasova D.S., Morozov D.D., Morozov D.A.


Purpose. This manuscript aims to introduce errors and complications of diagnosis and treatment in children with anorectal malformations (ARM).

Methods. A retrospective analysis of 63 children with ARM treated at a single tertiary Speransky children’s Hospital.

Results. The patients’ ages ranged from 2 mo to 17 y. o. (median, 6 y. o.). The types of ARM included: rectourethral fistula 27%, rectoperineal fistula 17.5%, rectovestibular fistula 15.9%, rectobladderneck fistula 6.3%, no fistula 7.9%, cloaca 11.1%, “cloaca” with urogenital sinus and disorder of sex development 1.6%, pouch colon 1.6%, rectal stenosis 4.8%, anal duplication 3.2%, and rectovaginal fistula 3.2%. Of these patients, 76% underwent surgery earlier at another hospital (surgical treatment completed), 14% had stomas, and 10% did not have any prior procedures. The historical analysis showed diagnostic errors in 48% of children (untimely diagnosis, incorrect interpretation of the ARM variant, prolonged delay in anorectoplasty). Errors led to emergency procedures or changes in subsequent surgical treatment (further ostomy, excess bowel resection) in 22% of cases. After anorectoplasty (stenosis, mislocated anus/rectum, rectal prolapse), complications were detected in 56% of cases, whereas ostomy complications were observed in 5% of cases. Long-term problems after the surgical treatment (constipation, incontinence, and pseudoincontinence) were evident in 98% of children. Different surgical reconstructive techniques of the sphincter formation had been performed previously in 13% of patients. Moreover, they most often had spinal pathology as the cause of functional disorders. Only half of the children’s parents had information about bowel management, 38% did not follow the recommendations and usually had fecal impaction and pseudoincontinence. 45% of children/parents performed non-effective or irregular enemas and required corrective treatment.

Conclusion. It is recommended that Russian pediatric surgeons treat children with ARM, according to Russian pediatric surgeons’ guidelines consistent with international protocols to avoid errors and complications.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2020;10(2):125-136
pages 125-136 views

Case reports

De Castro falloplasty of the with penile agenesis

Kagantsov I.M., Dubrov V.I., De Castro R.


Introduction. Penile agenesis (aphallia) is an extremely rare congenital disorder. At present, about 100 cases of the anomaly have been described around the world. The incidence of this congenital anomaly is estimated to be one case per 20–30 million births. One of the most commonly used reconstructive procedures today is the technique proposed by Roberto De Castro in 2007. In this article, we present a clinical case of aphallia in a boy who underwent phalloplasty.

Materials and methods. A newborn boy presented with aphallia, combined with abnormal development of both kidneys. At birth, the child had difficult urination through the fistula at the edge of the anus. The meatotomy and urethral dilation were performed on the fifth day of the infant`s life. On day 28 of the child`s life, surgical intervention was performed to remove the left non-functioning kidney and a right cutaneous ureterostomy because of the recurrence of febrile urinary tract infection. At 13 months, the tissue expander was installed above the pubic bone. At 16 months, the child underwent the De Castro phalloplasty technique while in the supine position.

Results. The child was examined 3, 6, and 12 months after the surgical treatment. Phalloplasty has had good outcomes as evaluated by parents and surgeons. At present, the boy is under the supervision of urologists, who plan to perform further surgical treatment of the urinary system.

Conclusion. Phalloplasty, in the case presented, had a good cosmetic result. In our opinion, it proved to be the correct initial stage of treatment for aphallia, an extremely rare genital malformation.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2020;10(2):183-191
pages 183-191 views

Endoscopic technologies in treatment 7-month-old child with multiple laryngeal cysts

Alkhasov A.B., Dyakonova E.Y., Lokhmatov M.M., Rusetsky Y.Y., Yatsyk S.P., Romanova E.A., Ratnikov S.A., Komina E.I.


Introduction. Subglottic cysts are a rare clinical entity among infants and children. The annual incidence of congenital laryngeal cysts is quoted as 1,82 per 100,000 live births. The majority of cases present in neonates born at the extremes of prematurity and invariably have been intubated and managed in neonatal intensive care units. Clinically, the pathology manifested as upper airway obstruction, stridor, and dysphonia. Various surgical techniques have been proposed for the treatment of patients with laryngeal cysts. In a large percentage of cases, tracheostomy is required, especially in patients with large cysts due to the development of symptoms of respiratory failure.

Purpose. The aim of this study is to demonstrate that endoscopic technologies in the treatment of laryngeal cysts in children can be useful to avoid tracheostomy and lead to an uneventful recovery.

Materials and methods. We present a clinical case of managing a 7-month-old child with multiple laryngeal cysts from the Department of Thoracic Surgery in the National Medical Research Center for Children’s Health Federal state autonomous institution of the Russian Federation Ministry of Health.

Conclusion. In the presented case, we demonstrate that modern minimally invasive techniques to treat laryngeal cysts restore the lumen of the respiratory tract. facilitate the course of the postoperative period, achieve complete patient recovery, and avoid tracheostomy.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2020;10(2):193-198
pages 193-198 views

Suprapatellar bursitis in a newborn

Erenkov I.O., Denisov I.S., Zarubina S.A.


Introduction. One of the most frequent pathologies in childhood is bursitis of the knee joint. Such conditions may occur in infectious pathologies, traumatic disorders, overuse syndromes, and other various pathologies. Diagnostic and treatment strategies depend on the cause of bursitis development. Particular attention should be paid to bursitis cases in newborns since the frequency of such pathologies is casuistic and clinical guidelines for treating patients in this age group are absent.

Materials and methods. A 26-day-old newborn arrived for consultation with complaints of knee joint pain and movement restrictions for four days. From five to 21 days of life, she has had in-patient treatment at another clinic because of pneumonia and a urinary tract infection. Intravenous and intramuscular injections of antibacterial drugs were prescribed for two weeks. The condition of the newborn was satisfactory upon consultation in our clinic. Her physical examination showed swelling and muscle tightness on the distal part of the thigh. The range of motion of the shinbone was restricted. Her blood test showed that her white cell count was unchanged. According to an X-ray examination of the knee, no pathology was detected. According to the US-examination, exudative suprapatellar bursitis was detected. The nonsteroidal anti-inflammatory drug, Nimesulid, was prescribed for seven days.

Results. Daily remote monitoring of the patient's well-being during treatment was performed. Movement restrictions reduced the swelling on day 3 of treatment. A follow-up blood test on day 4 of treatment showed no pathology. According to the follow-up US-examination after six days of drug therapy, no signs of bursitis were detected.

Conclusion. Inflammation of the suprapatellar bursa is a rare condition in newborns. In isolated cases of bursitis in children during the first year of life, a bacterial presence was noted, with the predominance of staphylococcal and streptococcal floras. However, in our opinion, there is a possibility of developing aseptic forms of bursitis in infants. In these cases, it may be prudent to refrain from prescribing courses of antibiotic therapy.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2020;10(2):199-202
pages 199-202 views

Clinical cases: acute appendicitis in newbons

Bocharov R.V., Pogorelko V.G., Yushmanova A.B., Karavaev A.V., Semchenko E.A.


Aim. The goal of this study is to describe the clinical observations of acute appendicitis in two newborn infants.

This study was a retrospective analysis performed using data obtained from medical records. Two preterm infants had a gestational age of 33 weeks, a threat of pregnancy termination, rapid childbirth in one case, and a cesarean section in another. At birth, their body weights were low, 2340 and 2420 g, respectively. The condition of the babies was evaluated on the Apgar scale, and both scored 7/8 points. We studied the data of clinical, laboratory, and instrumental study data and surgical intervention protocols.

In the presented newborns, neonatal jaundice, respiratory failure of the I–II degree, and hypoxic perinatal damage to the central nervous system occurred from birth. On the first child’s twelfth day and the second child’s ninth day, they experienced a clinically acute inflammatory process in the abdominal cavity, confirmed by inflammation markers (high white blood cell counts and levels of C-reactive protein). According to the sonography of the abdominal organs, the absence of intestinal motility in the right abdominal cavity, the presence of intestinal wall pneumatosis, signs of conglomerate formation from the intestinal loops were revealed. The surgical interventions performed were a laparoscopy and a conversion to laparotomy. In both cases, inflammatory bowel changes corresponded to the course of necrotic enterocolitis, diagnosed with gangrenous-perforated appendicitis and purulent-fibrinous peritonitis. In the section, the mucous appendix was not changed.

Conclusion. The aggravated premorbid background in premature infants predisposes them to necrotic enterocolitis, which can occur in children of this age with isolated perforation of the appendix. The course of necrotic enterocolitis is complicated by the formation of purulent-fibrinous peritonitis due to the destruction of the appendix with minimal changes in its walls.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2020;10(2):203-208
pages 203-208 views

Oxygenated salt enteral solution in the treatment of a child with pancreonekrosis

Bykov M.V., Prometneu D.V., Mayorov A.D., Mutsilkhanova M.M., Tyaglecova L.N., Fedyushkina V.O., Nafikov V.S., Sytkov V.V., Lazarev V.V.


Objective. This article describes the first experience of using an oxygenated salt intestinal solution (SIS) in the complex intensive care of functional intestinal failure (FIF) developed due to pancreonecrosis in a child aged 10 years 11 months after a blunt abdominal injury and burdened with concomitant alimentary factor.

Complex treatment was aimed to eliminate increasing endotoxicosis, pain syndrome, suspected secondary ischemia of the affected organs of the pancreaticoduodenal zone, restoration of motor and barrier functions of the intestine. In this connection, adjustments were made to the early enteral nutrition and enteral correction method using an oxygenated salt enteral solution (with a description of the oxygenation method), which allowed for 12 h to eliminate intestinal paresis, with the production of stool. According to the intestinal lavage method, repeated use of SIR-RA led to the significant persistent improvement in the patient’s condition and a decrease in inflammatory markers, which subsequently allowed the transition to adequate enteral nutrition. The patient was subsequently transferred to a specialized surgical Department and discharged from the hospital, and recovered with no signs of endocrine pancreatic insufficiency. Positive treatment results of a patient with pancreonecrosis complicated by FIF were made possible by improving intensive therapy tactics using an oxygenated salt enteral solution. The scheme of gradual enteral correction developed and used by us is an essential component of complex therapy of pancreonecrosis and functional intestinal insufficiency. The use of an oxygenated salt enteral solution helps to restore the main functions of the gastrointestinal tract.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2020;10(2):209-216
pages 209-216 views

Treatment of children with the complication of chemical burns of the esophagus

Sharipov A.M., Shamszoda K.A., Rahmatova R.A., Usupov B.K., Dodochonov U.T., Sayfulloev A.A., Ymarov Y.L., Khovari N., Akbarov U.A., Mazabshoev S.A.


Objective — to improve the results of treatment of children with cicatricial narrowing of the esophagus in various dilative ways.

The results of treatment of 95 patients aged from 1 year to 18 years with Cicatricial esophageal stenosis in the period from 2014 to 2019 were analyzed. There were 59 boys (62.1%) and 36 girls (37.9%). The patients were divided into two groups. The control group included 47 (49.5%) patients who had esophageal dilatations performed "blind" in 15 children and "thread" in 32 children, the main group — 48 (50.5%) patients who had esophageal augmentation performed using conductor screws. Of the 95 patients, 70 (73.7%) were after burning with acetic essence, 20 (21.05%) — after burning with alkali, 2 (2.1%) — after consuming potassium permanganate crystals, 2 (2.1%) — after swallowing a round battery, and another (1.05%) received a burn from an unknown chemical reagent. Diameters and lengths of narrowed sections were taken into account based on endoscopic and radiological data in order to select the appropriate sizes of branches in both groups.

18 (26%) of 70 children with scar stenosis after acetic essence were admitted to the hospital later than a month, with dilation of which in 4 cases (5.7%) there was a complication in the form of esophageal perforation, where two children had short scar stenosis, and the rest had tubular and elongated. The cases of complications in the control group were in three cases (two during blind bugging and one during bugging "for a thread"), and in the main group — in one. 20 (21.05%) children had scar stenosis after an alkaline burn, where extended scar stenosis was observed 6 (30%) patients. In the control group, 4 of patients had boujinga complications, and in the main group — 2. In 2 (2.1%) patients with Scar stenosis, which occurred after the potassium permanganate crystals were successfully run "along the thread". In two children, scar stenosis was formed after swallowing batteries, where one was reinforced with a "thread" (there was a perforation of the esophagus), and the other with a conducting string. Two children who received scar stenosis from an unknown reagent were reinforced with a conducting string, where in the first case a favorable result was achieved, and the outcome of treatment of the second child due to expanded stenosis was not successful. They were offered gastrostomy surgery to perform "thread" listening, but this offer was not accepted.

Conclusions. The obtained results reflect an advantage for bougienage on the conductor string in the treatment of children with cicatricial stenosis of the esophagus compared with other dilatation methods.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2020;10(2):217-226
pages 217-226 views


Modern view on the problem of urine diversion in children with severe urinary disorders

Ignatyev R.O., Guseva N.B., Romashin M.A.


Urination is a complex multicomponent process. Urinary disorders often lead to serious consequences on the urinary system, social maladaptation, and impairment of the quality of children's lives. Due to the large number of pathologies leading to these disorders and the involvement of several systems (for example, the nervous system in myelodysplasia), the doctor must be extensively knowledgeable and experienced in related fields. Surgical methods of urinary diversion have a long history. Surgeons worldwide have been trying to solve this problem for many decades, but it remains relevant and unsolved. The wide variety of urinary disorders has a correspondingly impressive number of types and options of surgical interventions. The goals of these surgical techniques are to correct the anatomical and clinical aspects of the disorders and assure the child’s socio-psychological adaptation. Surgeons must consider many factors such as all the pathogenetic nuances of an underlying disease, comorbidities, the child’s constitutional features, prospects for his or her social adaptation, the family home environment, parents’ willingness to and focus on long and challenging treatment. Based on these details, it is evident that urinary diversion in children is a multifaceted problem. It requires a very careful and individualized approach to each patient to ensure choosing the optimal treatment method in each case. This choice will affect many aspects of the child’s life, including his or her social adaptation, the ability to obtain an education and lead an almost normal lifestyle. The aim of this study is to review and systematize the accumulated knowledge on this subject.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2020;10(2):227-236
pages 227-236 views


Sedation and analgesia when performing vascular access in children

Bykov M.V., Lazarev V.V., Shchukin V.V., Diordiev A.V., Bagaev V.G.


The article discusses current approaches to anesthesia in providing vascular access in children in Russia and the framework of the existing problem and global practice. Several features of the child's body, such as small size, increased flexibility of the punctured vessel, expressed psycho-emotional and the child’s motor reaction to a potentially painful invasive procedure create significant additional difficulties in peripheral vein catheterization in children, especially at an early age, compared with adults. This fact until recently caused a high frequency of unsuccessful peripheral vein catheterizations in children and, as a result, a high percentage of punctures and central vein catheterizations, which in turn is associated with the risk of serious potentially life-threatening complications accompanying the puncture and catheterization of the latter. The article describes various, including non-pharmacological methods for inducing adequate sedation and analgesia during vein catheterization. The parents’ presence in the intensive care unit plays an essential role in non-pharmacological methods of child protection. It is a factor that reduces stress and psycho-emotional stress, both for the child and indirectly for the medical staff. Information from domestic and foreign sources on the use of various administration methods and various pharmacological drugs demonstrate the variety of approaches to solving this urgent problem. This article presents our research results showing the advantages of using a combination of methods and drugs that provide adequate anesthesia, expressed as an increase in successful peripheral vein catheterizations, the corresponding reduction in the unjustified number of central vein catheterizations, and the positive economic effect accompanying this dynamic.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2020;10(2):237-246
pages 237-246 views

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies