No abstract

Introduction. Treatment of respiratory failure in pneumonia caused by coronavirus infection (COVID-19) is still an unsolved problem that requires a comprehensive approach and the development of new methods that expand the range of possibilities of modern therapy. There is evidence that the heated oxygenhelium mixture has a positive effect on gas exchange in the infiltration zone by improving both ventilation and diffusion.AIM of study. To evaluate the effectiveness of the inclusion of a heated oxygen-helium mixture HELIOX (70% Helium/ 30% Oxygen) in the complex intensive care of respiratory failure of pneumonia caused by SARS-CoV-2 infection.Material and methods. The study included 60 patients with confirmed viral pneumonia caused by COVID-19. The patients were randomized into two groups: group 1 (n=30) — patients who were treated with the standard COVID-19 treatment protocol with the heated oxygen-helium mixture HELIOX, and group 2 (control) (n=30) — patients who received standard therapy. Lethality was studied for 28 days, the time in days until a steady increase in SpO2>96% was achieved when breathing atmospheric air; the time until the patient is transferred from the intensive care unit (ICU) to the general department.Results. Inhalation of the HELIOX mixture (70% Helium / 30% Oxygen) resulted in a faster recovery of the hemoglobin oxygen saturation index (SpO2). Starting from day 3, these differences became statistically significant. The time in days from inclusion in the study to a persistent increase in the degree of oxygen saturation of hemoglobin (SpO2>96%) when breathing atmospheric air in the group with inhalation of the HELIOX mixture was less — 8 (7; 10), compared to 10 (8;13) in the control group (p=0.006). In the group with inhaled HELIOX mixture, the median treatment time in the ICU was 8 (7; 9.5) days vs 13 (8; 17) days (p<0.001) in the comparison group.Conclusions. Inhalation of the HELIOX mixture (70% Helium / 30% Oxygen) led to a faster recovery of the hemoglobin oxygen saturation index SpO2, which contributed to reduction in the duration of oxygen therapy and a decrease in mortality.

Clinical pattern of the chronic decompression sickness is non-specific and there is objective difficulty to reveal the cause-and-effect relationship between the diver’s health condition and his professional activity in each case. This problem is not only obstructing necessary medical and social aid to the patient but also provides the light-minded relation to the preventive measures organization before diving long-term adverse health effects. A clinical case of professional pathology diagnosed in the diver. The patient served in 1993-2000 in Armed Forces of the Russian Federation as diver-welder, during this period no active complains were demonstrated, as he told, for saving diver’s qualification. In 2000 the patient retired for social and economic reasons and was accepted as a healthy person by a military medical expert commission. Until 2007 he was working by speciality not related to increased pressure terms. In 2007 after medical expert commission examination, the patient continued his work as a civilian personnel diver of the Russian Federation Ministry of Defense, during this time the clear relation between pain syndrome and diving episodes was detected. The patient was self-treated with analgesics and heat physical therapy with unstable effect. In 2014 because of increased lower back pain syndrome, he turned to medical aid. In2015 the diagnosis of chronic decompression sickness was established. Pathogenesis of chronic decompression sickness in not enough investigated, including methodical reasons. Prophylactic measures existing in routine medical diving practice are aimed only for acute non-specific and specific diver’s pathologies and this fact doesn’t favour special attention of the medicals for long-term post-diving effects. It provides to the low efficiency of measures for saving divers, aquanauts and caisson workers professional suitability despite known cases of their health disorders during work experience.