The effect of hyperoxia on the hemostasiological status of severely burned patients

Abstract

The state of the hemostasis system was studied in 9 patients of the middle age group (44 ± 9.94 years) who received thermal trauma on an area of more than 32% (49.4 ± 18.3) of the body surface, accompanied by the development of burn shock. The standard therapy for burn injury was supplemented with HBO sessions. Treatment with hyperbaric oxygen was carried out in pressure chambers BLKS-307, BLKS-307/1. The state of the coagulation, anticoagulant and fibrinolytic links of the hemostasis system, as well as the viscoelastic properties of the blood, were assessed immediately before the HBO session and immediately after it. The total number of comparison pairs was 45. Under the influence of HBO therapy, there was an increase in the activity of antithrombin III (ATIII), protein C (PrS) and a decrease in the viscoelastic properties of blood (p <0.05). Positive deviations in the values of ATIII, Pr C, von Willebrand factor, APTT, prothrombin and thrombin time, fibrinogen, factor XIII, XIIa-dependent fibrinolysis, D-dimers and thromboelastography parameters were revealed. The maximum frequency of their occurrence was recorded for ATIII (95%), the minimum - for the D-dimer (62%). After HBO procedures, undesirable deviations of the hemostatic system parameters were also noted. They were chaotic, were compensated by an increase in the activity of physiological anticoagulants and were not accompanied by complications of a thrombogenic nature. Thus, conducting HBO therapy sessions in the acute period of burn disease increases the activity of physiological anticoagulants and stabilizes the viscoelastic properties of blood. There is a high frequency of occurrence of positive effects of hyperoxia on the components of the hemostasis system. The identification of its undesirable effects indicates the need to monitor the state of the hemostasis system during HBO procedures.

A oxigenoterapia hiperbárica como tratamento complementar na abordagem terapêutica do paciente queimado: uma revisão integrativa

“…Os poucos resultados negativos provavelmente se devem a peculiaridades na administração da HBO e possivelmente também a interações durante a administração do tratamento a pacientes gravemente enfermos. (Presnyakova et al, 2021) O estado do sistema de hemostasia foi estudado em 9 pacientes da faixa etária média (44 ± 9,94 anos) que sofreram trauma térmico em uma área de mais de 32% (49,4 ± 18,3) da superfície corporal, acompanhado pelo desenvolvimento de queimadura choque. A terapia padrão para queimaduras foi complementada com sessões de HBO.…”

“…Foi possível observar o progresso de um paciente com ulceração durante a OHB e fornecer informações para o planejamento da duração do tratamento. Presnyakova et al (2021) observou em seu estudo o estado de hemostasia em 09 pacientes que sofreram trauma térmico em uma área de mais de 32% da superfície corporal após a OHB. Observou-se os efeitos positivos da hiperóxia na hemostasia.…”

SHock-INduced Endotheliopathy (SHINE): A mechanistic justification for viscoelastography-guided resuscitation of traumatic and non-traumatic shock

“…Hemostatic profiles of patients with BIC and hyperthermia have been studied with VHAs and demonstrate superiority to CCTs for detecting BIC (Marsden et al, 2017). Additionally, VHAs have shown to be an indispensable tool for identifying the cause of hypocoagulation in patients with severe burn injury (Presnyakova et al, 2021). ROTEM was also found to be useful in providing realtime guidance for the administration of blood products in severe burns (Bugaev et al, 2020).…”