PECULIARITIES OF ARTIFICIAL PULMONARY VENTILATION AT DIFFERENT STAGES OF SURGICAL CORRECTION OF VISCERO-ABDOMINAL DISPROPORTION IN NEWBORNS

Research objective: To optimize artificial lung ventilation based on the study of lung mechanical properties in newborns with viscero-abdominal disproportion during the perioperative period. Materials and methods: The study included 57 newborns, of which 15 (26.3%) had gastroschisis and 42 (73.7%) had omphalocele. All patients underwent intensive care and artificial lung ventilation using the Babylog device in volume control mode (A/C, SIMV/PSV). Hemodynamics and respiratory mechanics indicators (dynamic compliance - Cdyn, resistance - Rpk, pressure-volume and flow-volume loops) were continuously monitored using a graphical monitor. Intra-abdominal pressure was measured using the Kron method. Results: The study revealed a correlation between changes in intra-abdominal pressure at different stages and changes in respiratory indicators in newborns. In all patients, adaptation of the newborn's respiratory system was observed in the preoperative period. On the first day of the first stage of viscero-abdominal disproportion correction, a gradual decrease in dynamic compliance by 3.4 times was noted in both groups. Additionally, with a 2.42-fold increase in resistance, the PIP indicator rose to 20-22 cm H2O, and maximum changes in the indicators were observed on the graphical monitor. The indicators of lung mechanical properties returned to a relatively normal state by the end of the 72nd hour. The return of indicators of the mechanical properties of the lungs to a relatively normal state occurred at the end of the 72nd hour. Conclusion. An increase in intra-abdominal pressure to a high level leads to a change in respiratory mechanics and is a sufficiently informative criterion for correcting ventilation parameters. Conclusion: An increase in intra-abdominal pressure to a high level leads to changes in respiratory mechanics and serves as a sufficiently informative criterion for adjusting ventilation parameters. Moreover, a pronounced perioperative increase in intra-abdominal pressure (above 10-11 mm Hg) most strongly affects the mechanical properties of the lungs in newborns with viscero-abdominal disproportion.