Introduction. Harvesting of pooled platelet concentrates (PC) significantly expands the volume of transfusion support and could be used to create strategic platelet reserve.The aim of work. To compare the quality of pooled and apheresis platelet concentrates.Materials and methods. We studied platelet fractions (PF), isolated from the whole blood of cadre donors with Reveos system, platelet concentrates, obtained by pooling PF (Pooled PC), and platelet concentrates harvested by automatic apheresis. In all cases 2 days passed from the moment of blood donation to the platelet examination. In PC samples we studied cellular composition, morphofunctional parameters of platelets, pH and electrochemical parameters, hypotonic shock response.Results. The morphofunctional platelet rate in PF was significantly reduced, comparing to the normal levels. At the same time, the morphofunctional parameters of platelets did not significantly differ in PF and pooled PC. The pH values, the total content of platelets and leukocytes in the pooled PC corresponded to the requirements of The rules for procurement, storage, transportation and clinical use of donated blood and its components (2019). The total platelet count, the level of annexin-positive platelets, did not significantly differ in apheresis PC and pooled PC, hypotonic shock response was correct in apheresis PC and pooled PC. On the other hand, the level of platelets with granules in pooled PC was 1,8 times lower than in apheresis PC, other morphofunctional parameters of platelets in pooled PC were also reduced. Pooled PC were characterized by more positive level of open circuit potential and lower antioxidant capacity compared with apheresis PC on the same storage time.Conclusions. Platelet pooling with Reveos system is acceptable for obtaining PC doses that comply with Technical Regulations. Nevertheless, methods of pooled PC harvesting need further optimization.

Currently, there are no reference values for many laboratory indicators of homeostasis for gerontological patients, which complicates the objective interpretation of their disorders. Aim of study . Based on a comparison of the reference values of some laboratory indicators of homeostasis of volunteers over 65 and people of working age, we offer their conditional norm for people of gerontological age. Materials and methods . Studies of laboratory indicators of homeostasis were carried out in 25 volunteers aged 60 to 85 years. The comparison group consisted of 50 donors aged 18–59 years. Investigated indicators: lipid peroxidation and antioxidant blood system; factors of endogenous vascular regulation; apoptosis of peripheral blood lymphocytes; blood rheology; endotoxemia, immunology. Statistical analysis of the data was performed using the Statistica 10 software package (StatSoft, Inc., USA); when comparing the indicators, the nonparametric Mann–Whitney U test (abnormal distribution) was used. Results. In elderly and senile people, due to physiological aging, as well as the influence of endogenous and exogenous factors and concomitant diseases, there are significant differences in the reference values of some laboratory parameters from the parameters of the same name for people of working age.

Background poisonings with corrosive substances in russia retains a high proportion among acute exotoxemias. They are accompanied by severe homeostasis disorders with changes in hemorheological pattern in particular.Aim of study To evaluate the effect of the enteral correction of homeostasis (ech) on the hemorheological patterns in patients with acute poisoning with corrosive substances.Material and methods Patients with chemical burns of the mucous membrane of the esophagus of the 2nd-3rd degree and stomach of the 2nd-3rd degree who were treated at the n.v. sklifosovsky research institute for emergency medicine in 2017–2021 were examined. In 73 patients, ech was performed (study group), and 35 patients received standard treatment (comparison group). Indicators of hemorheological status were examined on the 1st, 3rd and 5th days in the course of ongoing therapy, as well as before and after intestinal lavage in patients of the study group. Statistical data analysis was carried out using the statistica 10 software package (statsoft, inc., usa).Results The first stage of ech, characterized by the use of intestinal lavage, has no negative effect on hematocrit, plasma viscosity and erythrocyte aggregation indices.The use of a glucosated enteral solution led to a decrease in plasma viscosity under normal hematocrit conditions at all follow-up periods. In patients of both groups, there was a decrease in blood viscoelasticity under conditions of high shear potential at all stages of the study, which indicates violations of the deformability of red blood cells. This process is more significant in individuals of the comparison group. The conducted studies have shown that standard treatment and ech for poisoning with corrosive substances have a corrective effect on the hemorheological profile aimed at stabilizing blood circulation, however, according to a number of indicators, the effect of ech is more pronounced.Conclusion The program of enteral correction of homeostasis and standard treatment for poisoning with corrosive substances have a unidirectional effect on the indicators of the hemorheological pattern. In cases of application of the enteral homeostasis correction program, the outstripping improvement of the majority of the studied hemorheological parameters is seen.

Introduction. In acute exogenous poisoning, hemorheological abnormalities are observed. Various extracorporeal, physico-chemical methods are used to correct them. There is an opinion that the enteral route of administration of corrective agents may be a more physiological way to restore homeostatic imbalances.Aim. To conduct a comparative assessment of the effect of glucosylated enteral solution and standard infusion therapy on hemorheological abnormalities in acute poisoning by psychopharmacological drugs.Material and methods. Patients with acute poisoning by psychopharmacological drugs who were treated at the N.V. Sklifosovsky Research Institute for Emergency Medicine in 2017–2021 were examined. Of these, 23 people, in whose treatment the enteral correction program was used, made up the study group, and 22 patients (the comparison group) underwent a standard set of therapeutic measures. Indicators of hemorheological status were examined on the 1st, 3rd and 5th days against the background of ongoing therapy. Statistical data analysis was carried out using the Statistica 10 software package (StatSoft, Inc., USA).Results. The use of a glucosylated enteral solution led to a reduction in plasma viscosity under normal hematocrit conditions at all follow-up periods. In patients of both groups, there was a decrease in blood viscoelasticity under conditions of high shear potential at all stages of the study, which indicates impaired red blood cell deformability. This process was more pronounced in individuals of the comparison group. The conducted studies have shown that the use of infusion therapy and glucosylated enteral solution in the early stages of acute poisoning by psychopharmacological drugs generally has a unidirectional positive effect on hemorheological indicators, contributing to the stabilization of blood circulation. At the same time, the effect of glucosylated enteral solution therapy is faster and more pronounced.Conclusions. The use of glucosylated enteral solution and infusion therapy as a supportive treatment in the early period of acute poisoning by psychopharmacological drugs in most cases has a unidirectional effect on hemorheological parameters. In cases of glucosylated enteral solution therapy, there was an outrunning positive dynamics on the part of the majority of the studied hemorheological parameters. Glucosylated enteral solution can be the method of choice as a maintenance therapy after the end of detoxification process for acute poisoning by psychopharmacological drugs.

Background. In acute poisoning, accompanied by a violation of the parameters of homeostasis, the problem of its management by the enteral route has been insufficiently studied.Purpose of the study. To assess the possibility of correcting electrolyte and volemic disorders of the body using an enteral solution (ER) in case of poisoning with psychopharmacological drugs.Material and methods. The study involved 120 patients who underwent intestinal lavage (IL) with ER on the 1st day in complex therapy. In the following days, 40 of them received infusion therapy, and 80 — drank glucose enteral solution (GES), 3–4 liters per day.Results. IL had a corrective effect on the electrolyte composition of the blood, volemic and hemorheological parameters, as well as on central and peripheral hemodynamics. The subsequent administration of GER had a stabilizing effect on these indicators, comparable to that of infusion therapy.Conclusion. In case of poisoning with psychopharmacological drugs, the use of saline enteral solution in the form of intestinal lavage and subsequent oral administration of the same solution in a daily volume of 3–4 liters, but with the addition of glucose, provides correction of impaired homeostasis indicators and may be an alternative to infusion therapy.

Цель исследования: оценка роли гемореологических расстройств в патогенезе развития тромботических осложнений у пациентов с тяжелой термической травмой. Материалы и методы. Проведен проспективный анализ результатов обследования 55 пациентов (13 женщин и 43 мужчин) в возрасте 1888 лет с тяжелой термической травмой, из них 19 больных имели инструментально подтвержденный эпизод тромбоза глубоких вен (ТГВ) нижних конечностей 36 пострадавших составили группу сравнения. Исследование вязкости и эластичности крови выполняли в шоковом периоде ожоговой болезни (1е и 3и сутки с момента травмы), токсемии (10е сутки) и септикотоксемии (2030е сутки ожоговой болезни) на капиллярном вискозиметре BioProfiler (США). Индексы агрегации эритроцитов в покое и в движении определяли на агрегометре MA1 (Myrenne GmbH, Германия). Результаты. У пациентов с ТГВ наблюдали значимое снижение показателя гематокрита и агрегации эритроцитов. Индексы агрегации были значимо ниже у пострадавших с тромбозами (14,7 1,2 и 26,4 1,9) по сравнению с пациентами без тромбозов (17,3 0,8 и 29,5 1,3), также как и параметры вязкости крови при скоростях сдвига 2,5 с1 (3,66 0,28 мПа против 5,70 1,14 мПа), 12,6 с1 (3,54 0,37 мПа против 4,40 0,39 мПа) и 62,8 с1 (3,65 0,26 мПа против 4,0 0,25 мПа). Эластичность крови при высокой скорости сдвига (62,8 с1) в группе с тромбозами была значимо ниже (0,23 0,02 и 0,55 0,14 мПа, соответственно). Заключение. Гемореологическое обследование обожженных с ТГВ нижних конечностей выявило снижение показателей эластичности крови и агрегации эритроцитов по сравнению с пострадавшими без тромботических осложнений. Сочетание вискозиметрии, эластометрии и агрегометрии крови позволяет создавать гемореологический профиль ожоговой болезни и проводить стратификацию обожженных по степени риска развития тромботических осложнений. Aim: to assess the role of hemorheological disorders in the pathogenesis of thrombotic complications in patients with severe thermal injury. Materials and methods. A prospective analysis of 55 patients examination (13 women and 43 men) aged 1888 years with severe thermal injury was performed: 19 patients had an instrumental confirmed episode of deep vein thrombosis (DVT) of the lower extremities, 36 patients formed the comparison group. We investigated blood viscosity and elasticity in the shock period of burn disease (1st and 3rd days after the injury), in the stages of toxemia (10th day) and septicotoxemia (2030th days of burn disease) on the BioProfiler capillary viscometer (USA). Erythrocyte aggregation indices at rest and in motion were determined on MA1 aggregometer (Myrenne GmbH, Germany). Results. In patients with DVT we observed a significant decreasing of hematocrit and erythrocytes aggregation. Aggregation indices were significantly lower in patients with thrombosis (14.7 1.2 and 26.4 1.9) compared to patients without thrombosis (17.3 0.8 and 29.5 1.3), as well as blood viscosity parameters at shear rates 2.5 s1 (3.66 0.28 mPа vs. 5.70 1.14 mPа), 12.6 s1 (3.54 0.37 mPа vs. 4.40 0.39 mPа) and 62.8 s1 (3.65 0.26 mPа vs. 4.0 0.25 mPа). The blood elasticity at high shear rate (62.8 s1) in the group with thrombosis was significantly lower (0.23 0.02 and 0.55 0.14 mPa, respectively). Conclusion. Hemorheological examination of burned patients with DVT of lower extremities revealed decreasing of blood elasticity and erythrocytes aggregation compared with the burned patients without thrombotic complications. The combination of blood viscometry, elastometry and aggregometry allows to create a hemorheological profile of burn disease and stratifies burned patients according to the degree of thrombotic complications risk.

Observations of 153 patients admitted to the toxicological department of the N.V. Sklifosovsky Research Institute for Emergency Medicine after severe poisoning with psychopharmacological agents (36), cauterizing fluids (67) and neurotoxicants (drugs of the opium group, ethanol and psychopharmacological agents) (50) were summarized. A hierarchical cluster analysis was used to assess the systemic response of the body to a chemical injury of varying severity and the treatment used. The data obtained shows that taking into account the complexity of the response of homeostasis indicators to various impacts the characteristics of the shifts to the manifestations of mentioned acute poisonings and treatment measures in the rehabilitation period with the use of cluster analysis should be evaluated using data that indicates changes in the strength of the bonds (proximity levels) both for individual indicators and for the values of intrasystemic connections in individual systems and between them. Cluster analysis provides an opportunity to obtain new information about the pathogenesis of the studied poisonings and also has predictive capabilities. Changes in the assessed indicators obtained by cluster analysis correspond to their shifts in the process of one dimensional analysis, positive results of treatment (reduction of treatment duration) and, therefore, are recommended for practical use.

We have undertaken the comparison of the results of the treatment and the changes in the laboratory characteristics of 25 patients that suffered a viper bite and were given the combined treatment either with the application of wave biomechanical therapy (WBMT) (10 patients comprising the study group), and without it (15 patients making up the control group). During the rehabilitation period, all the patients exhibited the common symptoms of intoxication including fever, shortness of breath, dizziness, nausea, dilated pupils, and rapid heartbeat as well as the local changes (burning sensation, redness of the skin at the site of the bite, decreased skin sensitivity, swelling, bruising, and blisters); other pathological conditions documented in the association with the snake bite included lymphangitis, lymphadenitis of the regional lymph nodes, and extensive swelling of the extremities with severe pain which were collectively responsible for the significant prolongation of the duration of hospitalization and required an additional treatment. The laboratory studies have demonstrated the multidirectional disorders of the hemorheologic patterns and of the cellular component of toxemia, such as deviations from the normal values of practically all hemorheological characteristics, mostly in the upward direction, moderate leukocytosis, and the increase in the amount of the dead white blood cells, as well as the significant enhancement of the indicators of endotoxemia including the leukocyte index of intoxication, and the coefficient of endogenous intoxication (a 1.8-5.7 times elevation, respectively). The application of the WBMT technology gave rise to positive clinical and laboratory dynamics (more pronounced in the patients of the study group than in those of the group of comparison) in the form of the reverse development of the general manifestations of intoxication and, especially, such local changes as reduced swelling, skin redness, bleeding, feelings of pain, normalization of body temperature and heart rate, restoration of skin sensitivity. The use of WBMT was accompanied by a full and pronounced correction of hemorheological disorders (viscosity and aggregation), and the 1.5-fold higher frequency of their effective correction in the treatment group compared with that in the control patients. There was an apparent tendency towards the normalization of endogenous intoxication and higher overall contents of the blood fractions of medium molecular weight peptides (MMP) (with the 1.2 and 1.4 times reduction in the levels of the MMP254 and MMP280 fractions, respectively) while leukocyte index of intoxication showed a statistically significant fall by a factor of 3.5 in comparison with its initial value. It is concluded that the introduction of WBMT in the combined therapeutic modality makes it possible to decrease the duration of hospitalization of the patients by 1.5 times (33%) on the average.

Observations of 153 patients admitted to the rehabilitation toxicological department of the Sklifosovsky Research Institute for Emergency Medicine after severe poisoning with psychopharmacological agents (36), cauterizing fluids (67) and neurotoxicants (drugs of the opium group, ethanol and psychopharmacological agents) (50) were summarized. To assess the systemic response of the body to a chemical injury of varying severity and the treatment used, the factor analysis method was used. For all of the estimated pathological conditions, high hemorrheological abnormalities are of high informational importance, especially during poisoning with psychopharmacological agents. The factor of endotoxicosis also has a noticeable effect, to the greatest extent during poisoning with psychopharmacological agents and cauterizing fluids. During the development of encephalopathy, the importance of blood viscosity, apoptosis and immune status is of informative significance. Factor analysis makes it possible to obtain new information on the pathogenesis of the studied poisonings. The data on the information value of the indicators used, obtained by the factor analysis, is in accordance with positive clinical results (shortening the hospitalization of patients), and therefore are recommended for practical use.

Observations of 153 patients admitted to the rehabilitation toxicological department of the Sklifosovsky Research Institute for Emergency Medicine after severe poisoning with psychopharmacological agents (36), cauterizing fluids (67) and neurotoxicants (drugs of the opium group, ethanol and psychopharmacological agents) (50) were summarized. To assess the systemic response of the body to a chemical injury of varying severity and the treatment used, the factor analysis method was used. For all of the estimated pathological conditions, high hemorrheological abnormalities are of high informational importance, especially during poisoning with psychopharmacological agents. The factor of endotoxicosis also has a noticeable effect, to the greatest extent during poisoning with psychopharmacological agents and cauterizing fluids. During the development of encephalopathy, the importance of blood viscosity, apoptosis and immune status is of informative significance. Factor analysis makes it possible to obtain new information on the pathogenesis of the studied poisonings. The data on the information value of the indicators used, obtained by the factor analysis, is in accordance with positive clinical results (shortening the hospitalization of patients), and therefore are recommended for practical use.

ABSTRACT. The paper presents the results of hemorheological parameters and coagulation study in 67 volunteers of three age groups, including young, middle-aged and elderly people. Studies have shown that values of the vast number of blood rheological parameters increase with advancing age, which is mostly significant after 60 years. Based on the findings, it is concluded that the presented results of hemorheological parameters studies in patients older than 60 years should be used as a comparison group in evaluation of the disease severity and the effectiveness of treatment for geriatric patients.

The objective of the present study was to compare the results of the treatment and changes in the measurements of the laboratory characteristics in the patients suffering from severe poisoning with the scolding liquids under effect of the combined treatment including the application of extremely high frequency electromagnetic radiation (EHF therapy). The study included ten patients given a course of EHF therapy and 10 ones treated without it. The patients of the two groups developed the oppositely directed alterations in the rheological properties of blood and hemostasis including the elevation of the hemorheological viscoelastic constituent, erythrocyte and platelet aggregation, the increase in blood viscosity at a high shear velocity and, conversely, its decrease at the low and moderate shear velocities and hematocrit. Moderate leukocytosis was observed during this period along with the 3-4 rise in the concentration of lymphocytes involved in the apoptotic process and the substantial increase (1,4 - 8,1 times) in the values of parameters of endotoxicosis (the leukocytic index of intoxication and the erythrocyte sedimentation rate). The use of EHF therapy for the management of this category of the patients at the stage of their medical rehabilitation produced a modulating hemorheological effect manifested as the reduction of the elevated hemorheological characteristics, with the especially pronounced increase in the parameters below the respective normal values. In the group comprising the control patients, the undesirable changes occurred more frequently than in the previous one; specifically, deviations of the parameters of interest from their normal values were more pronounced. EHF therapy resulted in the reduction of the concentration of dead leukocytes in blood and a two-fold decrease in the amount of lymphocytes at the later stages of apoptosis whereas the concentration of the lymphocytes just entering apoptosis was elevated; this situation reflected the process of sanogenesis. In contrast, this parameter decreased in the patients of the group of comparison. The reduction in the level of endogenous intoxication under effect of EHF therapy manifested itself as a more significant decrease of leukocytic index of intoxication and erythrocyte sedimentation rate in the patients of the main group in comparison with those of the group of comparison. It is concluded that the inclusion of EHF therapy in the combined treatment of severe poisoning with the scolding liquids reduces the time of epithelization of gastrointestinal mucosa by 4.7 days on the average. Accordingly, the duration of the hospital stay can be decreased by 3.8 days.