doiSerbia

Application of the ommaya reservoir in the treatment of hydrocephalus in prematurely born children: Correlation with animal results

Mihajlović Miljan (Univerzitetska dečja klinika, Beograd)
Mrdak Milan (Univerzitetska dečja klinika, Beograd)
Radlović Vladimir (Univerzitetska dečja klinika, Beograd)
Nikolić Igor (Klinički centar Srbije, Klinika za neurohirurgiju, Beograd + Medicinski fakultet, Beograd)
Rakić Miodrag (Klinički centar Srbije, Klinika za neurohirurgiju, Beograd + Medicinski fakultet, Beograd)
Repac Nikola (Klinički centar Srbije, Klinika za neurohirurgiju, Beograd)
Antunović Vaso (Klinički centar Srbije, Klinika za neurohirurgiju, Beograd + Medicinski fakultet, Beograd)
Janićijević Aleksandar (Klinički centar Srbije, Klinika za neurohirurgiju, Beograd)
Šćepanović Vuk (Klinički centar Srbije, Klinika za neurohirurgiju, Beograd)
Tasić Goran (Klinički centar Srbije, Klinika za neurohirurgiju, Beograd + Medicinski fakultet, Beograd)
Dučić Siniša (Univerzitetska dečja klinika, Beograd)

Introduction. Intraventricular hemorrhage occurs in almost one fifth of prematurely born children. Due to present complications, such as hydrocephalus and neurological deficit, it endangers the child’s life, therefore there is the need for understanding and prevent risk factors as well as the need for finding most optimal methods of treatment. Objective. The aim of the study was to point out the current therapeutic modalities of the treatment of posthemorrhagic hydrocephalus in prematurely born children. Methods. The study included 60 patients divided into two groups of 30 patients treated at the University Children’s Hospital of Belgrade in the period 2003-2008. Results. Treatment outcome of the control group of patients treated by standard methods was influenced by gestational age (p=0.024), head circumference on birth (p=0.043), body mass on birth (p=0.006), Apgar score on birth (p<0.001), peripartum asphyxia (p<0.001), cardiorespiratory arrest (p<0.001), respiratory distress (p=0.002) and intraventricular hemorrhagic grade (p<0.001). As statistically significant predictors of the poor treatment outcome of the experimental group of patients treated by using Ommaya reservoir were identified: low body mass on birth (p<0.05), low Apgar score (p<0.05), prolonged number of days on assisted ventilation (p<0.05), presence of peripartum asphyxia (p<0.05) and cardiorespiratory arrest (p<0.05). Conclusion. No statistically significant difference was detected in the outcome between the patients treated by the standard method and those with installed Ommaya reservoir. However, the difference of 10% in mortality between the two groups may be clinically significant so that further studies of larger samples are necessary.

Keywords: prematurely born child, intraventricular hemorrhage, hydrocephalus, treatment