Sepsis in newborns (Draft federal guidelines)

Neonatal sepsis is one of the most severe diseases of the neonatal period with a high probability of developing multiple organ dysfunction, septic shock and an unfavorable outcome. The purpose of this publication is to present draft federal clinical guidelines for the treatment of sepsis in newborns, which were developed taking into account the principles of evidence-based medicine. During the preparation of clinical guidelines, key questions were formulated using the PIPOH formula: P (population) — patient population and disease characteristics (neonate with sepsis and septic shock); I (interventions) — intensive care measures; P (professionals) — target audience of clinical recommendations (anesthesiologists, intensive care physicians, neonatologists, pediatricians, surgeons, infectious disease doctors); O (outcomes) — expected outcomes that can be improved (patient outcomes, health system indicators, epidemiological indicators, etc.); H (health care setting) — place of medical care (outpatient clinic, hospital, intensive care unit). The project includes sections on the etiology, pathogenesis and diagnosis of sepsis in newborns. Particular attention is paid to the issues of microbiological diagnostics, identification of the pathogen, antibacterial therapy, respiratory and nutritional support, extracorporeal hemocorrection, the use of intravenous immunoglobulins. It has been demonstrated that one of the mandatory elements of therapy is the early initiation of enteral nutrition using breast milk, the use of which is one of the most effective methods for the prevention of late sepsis in premature newborns with low and extremely low birth weight.