Vodyanitskaya S. Diagnostic and differential diagnostic criteria of severe respiratory distress in premature newborns during early neonatal period

126 premature newborns were examined during early neonatal period, including 20 infants with uncomplicated course of this period, 24 sufferring from respiratory distress syndrome (RDS) without neurological symptoms; 50 had RDS with the signs of hypoxemie affection of CNS; 32 neonates had RDS caused by birth spinal injury (BSI). It was revealed that changes of neuronspecific enolasa (NSE) level in the blood serum and cerebrospinal fluid (CSF) reflected hematoencephalic barrier condition, pathogenic mechanisms of RDS development and may be used for the purpose of differential diagnosis. In common the NSE level in the blood and CSF were increased in premature neonates not depending on the degree of prematurity. In the premature neonates with RDS the different types of NSE changes were revealed in the groups of infants with RDS, RDS + hypoxemie affections of brain, RDS due to BSI and in infants with uncomplicated course of the neonate period. These results were recommended to be used for differential diagnosis with the help of proposed diagnostic algorithm and special diagnostic coefficients. According to the recommendations it is necessary first to carry out differential diagnosis between RDS caused by BSI, then to compare RDS with hypoxic affection of brain and RDS caused by SBI. Key words: newborn, premature, respiratory distress, neurospecific enolasa, diagnostic algorithm.