Department of Pediatrics
Hospital of Lithuanian University of Health Sciences Kaunas Clinics,
Eivenių str. 2, LT-50009 Kaunas, Lithuania
Phone: +370 37 326626, fax +370 37 327160,
Head - prof. Rimantas Kėvalas
Phone: + 370 37 326963
The aim of the Clinic – to provide high level healthcare for 0-18 years children, to take part in the process of education of highly qualified specialists, to organize and conduct studies and research.
The structure of Pediatric Clinic:
- Pediatric emergency room (PER)
- Outpatient clinic
- I pediatric department
- II pediatric department
- Pediatric intensive care unit (PICU)
- pediatric critical care
- pediatric nephrology
- pediatric pulmonology
- pediatric allergology
- pediatric cardiology and reumatology
- pediatric oncohematology
- pediatric gastroenterology
History of the Pediatric Clinic reaches 1924, when department of children diseases was established in Kaunas University. Pediatric Clinic was founded in 1991. Assoc. prof. J. Bojarskas leaded the Clinic. Since 2000 prof. R. Kėvalas is the head of the Clinic.
Division of pediatric critical care
Division consists of Pediatric intensive care unit (PICU) and pediatric emergency room (PER). The mission of the division is to deliver intensive care service of the highest standards to every critically ill child and to consult every child admitting to our department. The PICU was founded in 1977. After the renovation and implementation of Swiss-Lithuanian project in 1995, current PICU has 8 well-equipped beds. The number of the annual admissions is approximately 1.200 (intensive care and post-operative care patients). PEM as a part of Pediatric Clinic was founded in 1999. The total number of admissions equals approximately 25.000 per year. Current PEM is able to consult every patient, to manage the emergency situations and to observe the patient for 24 hours if necessary. The scientific activities include several directions – bacterial infection and sepsis (SPROUT, SBI risk assessment, s.aureus infections in children), hospital acquired infection (national and international registries, colonisation routes of the lower airways in patients with endotracheal tube) and trauma (severe brain injury, therapeutic hypothermia, trauma registry). The classes for undergraduate students and also a part of pediatric and other residency programs are taking place in the division.
The Outpatient Clinic is a consulting unit within the framework of the Pediatric Clinic of Lithuanian University of Health Sciences Kaunas Clinics. The Outpatient Clinic provides specialized secondary and tertiary outpatient care for children under 18 years old. Official statistics reflect an average of 30 000 consultations and 45 000 visits per year.
The Outpatient Clinic provides the top level service, which is based on the consultations of distinguished 67 doctors of various specializations, assisted by 18 high qualified nurses. Among our members of staff we have 19 PhD doctors, 9 associate professors and 1 professor. Patients are consulted by pediatric alergologists, pediatric gastroenterologists, pulmonologists, pediatric nephrologists, pediatric hematologists, pediatric cardiologist-rheumatologists, pediatricians, pediatric surgeons, pediatric urologists, pediatric proctologist, children's orthopedics-traumatologists, otorhinolaryngologist, gynecologists, neonatologists, ultrasound specialist, and radiologists.
Patients could be sent for consultation to other clinics of Lithuanian University of Health Sciences Kauno Klinikos Hospital, such as pediatric neurologist, pediatric endocrinologist, children psychiatrist, psychologist and other specialists. The provision of outpatient health care services for the most recent modern diagnostic and outpatient treatment. The Outpatient Clinic is well equipped with modern technologies for diagnostics and treatment. Specialists of many medical specialties are working here. Regarding their competence, high qualification and selfless work using progressive methods of treatment, the most complicated diseases are diagnosed and cured. Accessibility to health care services in encouraged by paying attention to the process of performance procedures.
I pediatric department
I pediatric department consists of pediatric nephrology, pediatric pulmonology and pediatric allergology divisions.
Division of pediatric nephrology
Division was founded in 1996. It is composed of 15 beds. The number of the annual admissions is approximately 320. 2000 consultations/year are performed by pediatric nephrologists in Outpatient Clinic. 130 consultations inside the hospital.
All methods of renal replacement therapy are available:
- peritoneal dialysis,
- pediatric continuous renal replacement therapy (PCRRT),
The scientific activities include several directions:
- early detection of acute kidney injury;
- haemolytic uraemic syndrome: etiology and prognostic factors;
- etiology and treatment problems in recurrent urinary tract infection;
- the evaluation of the effectiveness of antimicrobial prophylaxis in infants with vesico-ureteral reflux grade III-V, started before the first symptomatic infection: international „PREDICT“ trial.
The classes for undergraduate students and also a part of pediatric and other residency programs are taking place in the division.
Division of pediatric pulmonology
Division of pediatric pulmonology is based in I-st department of children diseases.
Currently, pulmonology division activities are carried out as follows:
- Ambulatory patient counseling in the children Outpatient Clinic,
- Stationary pulmonology patient examination and treatment,
- Pedagogical work
- Scientific work
Highly qualified specialists – children pulmonologists and pulmonologists-allergists work in the division. They consult children from all of Lithuania.
Within the division every year about 1000 are treated, over 3000 children with respiratory and allergic diseases are consulted in the Outpatient Clinic. Additionally patients with severe chronic lung diseases - uncontrolled asthma, cystic fibrosis, and other purulent and interstitial lung diseases are observed and treated.
All of the technical capabilities present in Kaunas Clinics are being used for children respiratory tract illness diagnosis and treatment.
- Detailed allergological baby and child examinations are possible for the determination of the allergic respiratory diseases nature. Allergy skin prick tests are performed to identify inhaled allergens, food and inhalable allergens specific IgE antibodies in the blood serum are analyzed, cytological nose secretion examinations are performed.
- In order to examine children respiratory functions new computer hardware Vmax which corresponds to global quality standards is used. For children over 7 years of age spirometry, provocation and bronchodilatation tests are performed. Besides routine analysis lung capacity, gas diffusion on the lung alveoles - capillaries level, respiratory muscle force examinations are possible. Such in vetigation is very important for children with chronic lung diseases. Young, 3-7 year old children respiratory function can be evaluated using the Jaeger MasterScope spirometer, which is specifically designed for smaller children. Airway resistans of toddlers can be measured by impulse oscillometry (IOS) method, which does not require the active participation of the child during examination.
- Experienced specialists perform bronchological examinations. Diagnostic and therapeutic bronchoscopy in the Clinic of children diseases is performed to all ages of infants and children.
- Specialists of the Pediatric Clinic also use the newest of radiological examinations (computed tomography, nuclear magnetic resonance examination, positron emission tomography, contrast, radioisotope analysis). Ultrasound examinations are widely used. Using various methods of visualization procedures such as pleural puncture and drainage or lung tissue transbronchine or transthoracic biopsy.
- In order to achieve the best in children respiratory diseases diagnosis and treatment, we collaborate with specialists from other fields – ear-nose-throat doctors, children surgeons, oncologists, neurologists, immunologists, radiologists, microbiologists, geneticists. All Kaunas Clinic laboratory facilities are used for diagnosis of pulmonary and allergic diseases. Complicated biochemical, immunological and microbiological examinations are possible on ill children.
- In order to give qualified help for children with chronic respiratory diseases the Centre of Pediatric chronic respiratory diseases was founded in the Pediatric Clinic. Patients with cystic fibrosis and other chronic purulent and interstitial lung diseases are examined, treated and constantly monitored. The use of the newest respiratory tract monitoring means - cough assistants and vibrational jackets – allow for top quality monitoring and treatment of patients.
- Close collaboration with children intensive care doctors and neurologists allow for development of assistance for children with neuro-muscular diseases. Pediatric Clinic is the only one in Lithuania, where home long-term non-invasive ventilation is selected, adapted and ensured for the pediatric patients.
Highly qualified specialist knowledge and wide diagnostic possibilities allow for diagnosis and effective treatment of not only common children respiratory organ diseases but also rare and complicated illnesses.
6 doctors of the pulmonolgy sector are PhD in Pediatric Pulmonology and Allergology topics, trained in European and U.S. hospitals. These are throughout the country known specialists. They are in charge of scientific studies, prepare treatment guidelines for lung and allergic diseases and give lectures and presentations in republic and international conferences.
Children pulmonologists actively participate in international scientific projects regarding problems of children respiratory system diseases. The data of international projects ISAAC (International Study of Asthma and Allergy in Children) and SPACE (Study on Prevention of Allergy in Children in Europe) are well known not only in Lithuania, but also in all of Europe.
In the division of pediatric pulmonology educational work is also actively practiced. Every year around 300 of students study pediatric respiratory diseases. Jung doctors are prepared according to the Pediatrician and pediatric pulmonology residenship program. Pediatrician, pediatric pulmonologists, other specialists and family doctors come from all across Lithuania to the Pediatric Clinic to improve their pulmonology knowledge and increase their professional qualification.
Division of pediatric allergology
Pediatric allergology division is one of the division at the 1st department of Children Diseases. Children ill with the most severe allergic diseases are being consulted and treated at the hospital and in outpatient clinic.
Consulting doctors are well known, high quality doctors, who underwent specialization at variuos clinics in Europe and USA.
In the process of diagnosing and treating children who are ill with allergic diseases, all laboratory and other examination techniques at Kaunas Clinic are used. Infants and children can be examined by performing skin prick tests, patch testsm evaluating specific IgE for food and ingalant alergenus, nasel, bronchial secretions lung function.
Seriously ill children can be treated with the help of plazmapheresis.
Often ill children can be examined for having variuos immunodeficiences and if diagnosed – treated every month with intravenous immunoglobulin.
Pediatric allergologists are widely invalved in preparing methodological recommendations and textbooks about children allergic diseases: diagnostic and treatment. They are lecturers at NATIONAL and international conferences, taking part at international projects (ISAAC, SPACE, 7BPHELIX) dealing with risk factors of allergic diseases.
Pediatric allergologists ar involved in teaching process – giving lectures for students, pediatric and family doctors residents and doctors at postgraduate courses.
II pediatric department
II pediatric department consists of pediatric cardiology and rheumatology, pediatric oncology and hematology, pediatric gastroenterology divisions.
Division of pediatric cardiology and rheumatology
Clinical work at pediatric cardiology division
Consulted and treated children with congenital and acquired heart diseases, gained a considerable experience in examining and treating the children of all ages for rhythm disturbances. Transesophageal electrophysiological studies of the conductive system of the heart are performed, for the older children they can be performed in outpatient conditions. The intracardiac transcatheter examinations of the conductive system of the heart and radiofrequency ablation procedures are performed in children suffering from supraventricular and ventricular tachycardias. Approximately 20 –30 radiofrequency ablation procedures per year are performed in our Clinic. Cardiac ultrasound studies are performed for children in Outpatient Clinic and for patients from other departments, including newborn infants in neonatology clinic.
Pediatric rheumatology division
Children with joints and systemic connective tissue diseases are treated. The novel methods of treatment with biological therapy drugs (etanercept, adalimumab, infliksimab) are used. Applied the treatment with intraarticular steroid injections for children suffering from joints inflammatory diseases.
The scientific and pedagogical work
Two residents constantly are studying and working in Pediatrics Cardiology residency, and in the future we will teach the residents studying in Pediatric Rheumatology. The lectures, seminars are held, the residents are trained to carry out the practical procedures. The students of Medial faculty of Lithuanian University of Health Sciences carry out scientific work in the field of pediatric cardiology and rheumatology. Each year the works are delivered to the SMD conferences.
Pediatric oncology and hematology division
The first patients with malignant tumors were started to treat in II department of the Pediatric Clinic in 1997. The division of children‘s oncology and hematology was established in 2005. It was composed of 10 beds. After the reconstruction of ht Pediatric Clinic the new bdivision of children‘s oncology and hematology was opened in 2012. This is a modern isolated division with 15 beds and all nessesary equipment, that is required for treatment children with malignant tumors and blood diseases. The patiens with hematological disorders are consulted in Outpatient Clinic every workday.
The team of specialists composed of doctors pediatric oncologists-hematologist, nurses, psychologist, social worker and rehabilitologist works in this subdivision (unit) providing care for patients with cancer.
Clinical work areas - children's hematological disorders, children’s malignant tumors, especially central nervous system tumors.
A new children's hematology residency program is prepared and approved.
The scientific and pedagogical work is carried out. Three PhD‘s theses were defended and one doctoral work is ongoing now.
All doctors of the division of children‘s oncology and hematology are members of Nordic Organisation of pediatric hematology and oncology (NOPHO), Lithuanian society of hematology, Baltic society of pediatric oncology and hematology (BSPOH).
Pediatric gastroenterology division
Clinical activity-ambulatory and stationary treatment.
Children with various illnesses of directory system (DS) are advising and treating.
New methods of diagnostics and treatment of illness of DS are created. Assoc. prof. R. Kučinskienė made science tests witch shown H. Pylori infection role in pathology of children illness of DS and presented recommendations of diagnostics and treatment. We are carefully look at diagnostic and treatment of chronic intestines influence illness (CIII). The registry of CIII has been created.