Кровопотеря

Kursov, S.V.; Nіkonov, V.V.; Skoroplit, S.M.

doi:10.22141/2224-0586.1.96.2019.158741

Cited by 3 publications

(1 citation statement)

References 11 publications

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“…A special feature of the examined patients was the staged surgical correction in all cases according to the Damage Control concept. The volume of blood loss was assessed using Moore's formula [18]. Hemodynamic parameters were determined according to the method of integral rheography, developed by Kubicek and were processed on a DX-Reo complex by "DX-Complex" (Ukraine) [19].…”

Section: Methodsmentioning

confidence: 99%

Indicators of cellular metabolism alterationsin patients with traumatic disease due to hypoxia, depending on a management regimen of intensive care

Matvieienko

Belozorov

Shamoun

et al. 2021

ZMJ

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The aim of this study was to evaluate changes in the level of erythrocyte metabolism under conditions of hypoxia in patients with traumatic disease in polytrauma depending on the components of intensive care (IC). Materials and methods. A prospective study was carried out in 88 patients suffering from polytrauma in the period from 2015 to 2017. All the patients were divided into 2 groups, comparable by severity of trauma and condition. A special feature of the examined patients was the staged surgical correction in all cases according to the Damage Control concept. Patients from the Control group received an intensive care according to the standard local clinical protocol in polytrauma. Patients randomized to the FDP group were treated with infusion of D-fructose-1,6-diphosphate sodium hydrate in addition to the standard care. Hemodynamic parameters and cellular metabolism indicators were monitored: on admission to the operating room, after 24 hours, on day 3, 5 and 14. Results. The signs of hypovolemia were equally severe in both groups on admission to the operating room. The FDP group demonstrated more rapid stabilization of hemodynamics and improved myocardial contractility at the 3rd day of IC. The monitoring of acid-base balance and carbohydrate metabolism showed the presence of compensated metabolic acidosis and energy deficiency. High indexes of lactate/pyruvate indicated a sharp imbalance in the ratio of aerobic/anaerobic metabolic processes. The analysis of ATP dynamics displayed impaired mitochondrial ATP production and inhibition of the glycolytic pathway of energy release. Conclusions. Complementary systemic inflammatory response with the elevation of lactate level by the 5th day occurred in patients with traumatic disease who underwent staged surgical correction. Optimization of intensive care resulted in a faster restoration of the balance between aerobic and anaerobic metabolic processes, an increase in the level of ATP and the rate of 2,3-DPG production in erythrocytes contributing to adequate oxygen supply to the tissues, supporting cellular respiration and preventing the development of oxidative tissue damage, as well as helped to maintain compensatory mechanisms and reduce cellular hypoxia ensuring adequate metabolism of vital organs.

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Section: Methodsmentioning

confidence: 99%

Indicators of cellular metabolism alterationsin patients with traumatic disease due to hypoxia, depending on a management regimen of intensive care

Matvieienko

Belozorov

Shamoun

et al. 2021

ZMJ

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Pre-clinical evaluation of effectiveness of infusion solutions with different osmolarity during acute blood loss in experiments on rats

Shperling,

Krupin,

Arokina

et al. 2024

Sibirskij nauchnyj medicinskij zhurnal

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The aim of the research was to experimentally evaluate the effectiveness of infusion solutions with different osmolarity during acute blood loss in experiments on rats. Material and methods. Experiments approved by the local Ethics Committee, have been done on 30 male rats line Vistar (320 ± 35 g). Design of the research included anesthesia, simulation of acute blood loss to 50 % of circulating blood volume, its replenishment with experimental infusion solutions based on polyglycan derivatives (estimated osmolarity 1026.6, 1784.2, 2566.6 mOsm/l), research of survivability, functional state of cardiovascular and respiratory systems, blood acid-base status and gas partial pressure 5, 30, 60, 120, 180 min after the beginning of replenishment of circulating blood volume. The infusion solution Hemostabil was used as a comparison product. Results. The highest survival rate, restoration of hemodynamics and acid-base state and blood acid-base status and gas partial pressure were obtained as a result of infusion of solution with osmolarity 1026.6 mOsm/l. In this group of animals survivability accounted for 100 %, arterial pressure restored in 5 minutes after the start of infusion, indicators of blood acid-base status and gas partial pressure normalized in 120 min of experiment. All of the results had statistically significant differences (p < 0.05) relative to values in other experimental groups. Conclusions. Sample of solution with osmolarity 1026.6 mOsm/l is the most effective in restoration of hemodynamics of rats with the blood loss up to 50 % of circulating blood volume. The expediency of the researches of safety of this infusion solution based on polyglucan derivatives in the capacity of medication for replenishment acute blood loss is substantiated.

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To the question of establishing the severity of bodily injuries in open fractures of the lower limbs

2020

Actual Problems of Modern Medicine

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Summary: Currently existing "Rules for determining the severity of bodily injuries" do not correspond to the modern classification, the level of knowledge about clinical course and outcomes of open fractures of the lower extremities. Purpose - to conduct a comparative retrospective analysis of forensic medical examinations results to determine the severity of bodily injuries in victims with open and closed fractures of the lower extremities. Material and methods. Research material - 425 acts (170 primary, 185 commissions, 70 complex) forensic medical examinations of victims with fractures of the femur and / or tibia, performed in the Kharkiv Regional Bureau of Forensic Medicine for the period February - June 2018. Research methods - retrospective analysis, descriptive statistics. Results. It was found that both at the time of injury and in the event of its (injury) consequences in victims with a leading injury of the lower extremities, open fractures of the femur and tibia are assessed as severe bodily injuries without taking into account the nature of the fracture and the degree of damage to soft tissues (according to generally accepted classifications), although these data determine the features of treatment measures and the prognosis of trauma at the prehospital and hospital stages. Conclusions. Open fractures of long bones of the lower extremities of type I and II in clinical course, treatment approaches, a risk of complications differ significantly from open fractures of type III. Acute blood loss and hemorrhagic shock, which develop in fractures of long tubular bones as a result of damage of intraosseous, periosteal and muscle vessels, are characteristic of both open and closed fractures. The complicated consequences of open fractures of the lower extremities described in the literature are not life-threatening. The severe bodily injuries revealed as a result of this study were mainly the result of non-union periarticular and intra-articular fractures with persistent joint contracture. The above facts indicate the need to correct the "Rules for determining the severity of injuries" in the case of open fractures of long tubular bones and their differentiated use in fractures of varying complexity with varying degrees of soft tissue damage.

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Кровопотеря

Cited by 3 publications

References 11 publications

Indicators of cellular metabolism alterationsin patients with traumatic disease due to hypoxia, depending on a management regimen of intensive care

Indicators of cellular metabolism alterationsin patients with traumatic disease due to hypoxia, depending on a management regimen of intensive care

Pre-clinical evaluation of effectiveness of infusion solutions with different osmolarity during acute blood loss in experiments on rats

To the question of establishing the severity of bodily injuries in open fractures of the lower limbs

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