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

2021 ◽  
Vol 66 (11) ◽  
pp. 666-672
Author(s):  
M. V. Presnyakova ◽  
V. I. Zagrekov ◽  
O. V. Kostina ◽  
Artem Sergeevich Pushkin ◽  
V. L. Kuznetsova ◽  
...  
Keyword(s):  
Viscoelastic Properties ◽  
Burn Injury ◽  
The State ◽  
The Body ◽  
Burn Shock ◽  
Thrombin Time ◽  
Positive Effects ◽  
Hemostasis System ◽  
Burn Disease ◽  
Von Willebrand

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.

scholarly journals Тhe use of corticosteroids in patients with severe burn injuries

2020 ◽  
Keyword(s):  
Burn Injury ◽  
Burn Shock ◽  
Burn Patients ◽  
Severe Burn ◽  
Septic Complications ◽  
Results Of Treatment ◽  
Adults And Children ◽  
Severe Burn Injuries ◽  
Burn Disease ◽  
Severe Burn Injury

Modern treatment of burns has led to a significant reduction in mortality in patients with burns whose injuries were fatal several years ago. However, along with improved survival, new problems arose in the treatment of burn patients. Systemic inflammatory response, capillary leak, sepsis top the list of the most common problems in both adults and children with severe thermal injury. Currently, new strategies are being developed and studied in the treatment of this category of patients. One of the ways to improve the results of treatment of patients with severe burn injury is to prescribe corticosteroids, both in the stage of burn shock and in the development of septic complications. Do corticosteroids reduce mortality and improve recovery in burn patients? The discussion about this has been going on for many years, but the opinion about their effectiveness remains controversial. An analysis of the literature shows that corticosteroids can play a significant role in the treatment of patients with severe burn injury and can be successfully used at any stage of a burn disease. The effect of reducing capillary leakage, increasing myocardial contractility, antiemetic, membrane-stabilizing effect of corticosteroids will be useful in the stage of burn shock. The anti-inflammatory, immunomodulatory effect of corticosteroids will play a role in any stage of a burn disease. With the aim of preventing and treating sepsis, corticosteroids may be useful in the stage of toxemia, septicotoxemia. It is also necessary to remember about adrenal insufficiency, which develops in burn patients. The article analyzes the literature, substantiates the use of corticosteroids in patients with severe burn injury in different periods of a burn disease.

Features response and course of typical pathological processes in burn disease in puberty

2015 ◽  
Vol 6 (4) ◽  
pp. 69-74
Author(s):  
Anastasia Grigorievna Vasilyeva ◽  
Evgeny Vladimirovich Zinoviev ◽  
Denis Valerievich Kostyakov
Keyword(s):  
Burn Injury ◽  
Endocrine System ◽  
Qualitative Change ◽  
The Body ◽  
External Shocks ◽  
Metabolic Processes ◽  
Burn Victims ◽  
Adaptive Capabilities ◽  
Burn Disease ◽  
Almost All

In response to burn injury in the body of the child in puberty naturally develop typical pathological processes, which include almost all organs and systems, leads to severe disruption of homeostasis failure of adaptive mechanisms. Burn is the most powerful stress factor that causes changes in the body that are typical of the general adaptation syndrome. The main pathogenesis and peculiarities of typical pathological processes in burn disease significantly affected are determined by the endocrine system. Produce hormones are involved not only in the starting mechanism, but also in the development of compensatory-adaptive reactions, mobilizing the body's protective properties. Thus, a feature of adolescence is that at this age the body undergoes a qualitative change to the restructuring of all systems. There are significant morphological and functional restructuring of important metabolic processes in the body organs like the pituitary gland, adrenal glands, thyroid and pancreas, characterized by high activity of metabolic processes, strengthening of cell and tissue differentiation, intensification of regenerative processes. The consequence is excessive functional activity of organs and systems at rest, associated with low and often paradoxical reactivity to external shocks, including a burn injury, which leads to a decrease in functional and adaptive capabilities of the organism adolescents. All these features to consider when choosing the strategy of surgical treatment of persons puberty, burn victims.

scholarly journals The features оf immunopathogenesis of sepsis and immunodiagnostics in severely burned patients

2021 ◽  
pp. 95-103
Author(s):  
E. V. Zinoviev ◽  
A. V. Dergunov ◽  
M. G. Kobiashvili ◽  
V. F. Mitreikin ◽  
K. S. Shulenin
Keyword(s):  
Body Surface ◽  
Peripheral Blood ◽  
Burn Injury ◽  
Surface Group ◽  
The Body ◽  
Skin Area ◽  
Early Sepsis ◽  
Group 2 ◽  
Burn Disease ◽  
Microsoft Office

Intention. To study the possibility of predicting early burn sepsis based on the content of proinflammatory cytokines in the peripheral blood of patients with extensive burns.Methodology. The study included 60 patients (of them 37 men) aged 21 to 58 years (mean age 46.8 ± 9.3 years) with extensive skin burns (Degree III burns by ICD 10 from 20 to 60 %, average 34.1 %, of the body surface). Depending on the skin area affected and the course of burn disease, the patients were divided into three groups, each of 20 patients: group 1 - the course of burn disease without early sepsis, burn area from 21 to 40 % of the body surface; group 2 - the course of burn disease without early sepsis, burn area from 41 to 60 % of the body surface; group 3 - the early burn sepsis, burn area of 20 to 60 % of the body surface. To achieve the goal of the study, all the patients underwent sequential peripheral blood sampling 24 and 72 hours after a burn injury. The levels of IL-1β, IL-6, IL-10, and TNFa were analyzed in the obtained samples. Data were processed using Microsoft Office Excel 2007 and IBM SPSS 20.0 by methods of descriptive and non-parameter statisticsResults and Discussion. The analyzed indicators statistically significantly correlated with the severity of burn injury and the likelihood of burn sepsis. Decreased concentrations of IL-1β, IL-6 and TNFα within Days 1-3 after getting a burn suggest a relatively favorable course of burn disease. No significant positive dynamics of these laboratory parameters may indicate a high probability of developing early burn sepsis.Conclusion. Concentrations of IL-1β, IL-6 and, especially, TNFα in the peripheral blood make it possible to predict early burn sepsis.

OPTIMIZATION OF INTENSIVE THERAPY FOR BURN SHOCK

2021 ◽  
Vol Special issue (1) ◽  
pp. 44-50
Author(s):  
Xusniddin Jumanov ◽  
◽  
Ishnazar Mustafakulov ◽  
Xudoyberdi Korabaev ◽  
Yokubjon Hursanov ◽  
...  
Keyword(s):  
Intensive Therapy ◽  
The Body ◽  
Burn Shock ◽  
Treatment Principles ◽  
Burn Disease

The literature provides about 100 different definitions of the concept of shock(G. Bernard, 2001). A large number of definitions of the concept are directly dependent on the reasons that caused it. Burn shock is the first stage of burn disease and develops when the surface of the body is affected by an area of 10-15% for superficial and 5-10% for deep burns.This article discusses the optimization of intensive therapy for burn shock.Keywords:pathogenesis, stages of burns, treatment principles, Evans formula, criteria for recovery from shock

Immune Consequences of Burn Injury

1993 ◽  
Vol 4 (2) ◽  
pp. 399-413 ◽  
Author(s):  
Melva Kravitz
Keyword(s):  
Immune System ◽  
Burn Injury ◽  
Antibiotic Use ◽  
Immune Defense ◽  
The Body ◽  
Burn Shock ◽  
Electrolyte Balance ◽  
Burn Wound ◽  
Vascular Access Devices ◽  
Major Burn

The purpose of the immune system is to protect cells from invasion by microorganisms. The body has three equally important interactive immune defense systems, all of which are profoundly disrupted with major burn injury. The immune response to burn injury is immediate, prolonged, and severe. The end result in individuals surviving burn shock is immunosuppression, with increased susceptibility to potentially fatal systemic burn wound or pulmonary sepsis. Nursing actions to support the humoral and cell-mediated immune system of the burned patient include providing nutritional support to maintain serum protein levels at optimal levels; measures to decrease edema and promote angiogenesis in areas of partial-thickness injury; meticulous treatment of the wound to prevent infection and promote healing; monitoring of antibiotic use; conservative use of invasive techniques, including intubation and vascular access devices; maintenance of fluid and electrolyte balance and body temperature; and energy conservation measures

scholarly journals INFLUENCE OF HEPARINOID FROM PAEONIA LACTIFLORA ON HEMOSTATIC SYSTEM WITHIN CONDITIONS OF PRETHROMBOSIS

2019 ◽  
Vol 7 (4) ◽  
pp. 208-214
Author(s):  
M. G. Lyapina ◽  
M. S. Uspenkaya ◽  
E. S. Maistrenko ◽  
M. D. Kalugina
Keyword(s):  
Oral Administration ◽  
Blood Plasma ◽  
Fibrinolytic Activity ◽  
The State ◽  
The Body ◽  
Thrombin Time ◽  
Paeonia Lactiflora ◽  
Fibrin Polymerization ◽  
Reference Drug ◽  
Hemostatic System

The search and development of direct and rapid anticoagulants used per os, is an urgent problem in physiological and medical science. A number of plants contain heparin-like components with a positive effect on the hemostatic system, both within normal and in some pathological conditions of the body.The aim of the work was to study the complex effect of fibrin, a heparin-like substance (heparinoid) from the roots of Paeonia lactiflora, on fibrinolytic, anticoagulant systems of the body and polymerization processes, when it is administered per os in animals within normal conditions and when modeling the state of prethrombosis.Materials and methods. To carry out the research, the roots of Paeonia lactiflora growing in the Botanical Garden of Moscow State University, and laboratory animals – male Wistar rats – were used. To study the antithrombotic effects of the extract from roots containing heparinoid, the state of prethrombosis was modeled in rats. The determined parameters of hemostasis were: anticoagulant activity according to the tests of activated partial thromboplastin time and thrombin time, fibrinolytic activity according to the test of total fibrinolytic activity, fibrin polymerization according to the test of fibrindepolymerization activity of blood plasma.Results. With repeated (every 24 hours within 3 days) oral administration of the extract containing heparinoid, in animals within normal conditions and with prethrombosis, the following anticoagulant effects were established in the blood: an increase in anticoagulant, fibrindepolymerization and fibrinolytic plasma activity. Possible mechanisms of the activating effect of heparinoid on fibrinolysis and anticoagulant properties of plasma due to the excretion of tissue plasminogen activator into the bloodstream from the endothelium, thrombin inhibition, and fibrin polymerization are described. Moreover, the anticoagulant effect of the use of the extract from the peony roots was equivalent to that of the reference drug of low molecular weight heparin from Celsus (USA). For the first time, it was revealed that when modeling experimental prethrombosis, the administration of heparinoid in rats at the dose of 37.5 IU/kg МЕ/кг body weight restored impaired hemostasis, which requires a further study.Conclusion. The ability of heparinoid from peony roots to normalize the functional state of the anticoagulant system during the development of prethrombosis in animals has been established. The restriction of fibrin polymerization during oral administration of heparinoid from peony in animals by increasing the enzymatic fibrinolytic and fibrindepolymerization activity of blood plasma was revealed. In the future, heparinoid can be used as an antithrombotic agent.

scholarly journals Intestinal fatty acid binding protein as a marker of damage intestinal barrier in children with burn injury

2020 ◽  
Vol 23 (2) ◽  
pp. 101-105
Author(s):  
Ольга Владимировна Костина ◽  
Елена Анатольевна Галова ◽  
Владимир Израильевич Ашкинази ◽  
Ирина Геннадьевна Стрелкова
Keyword(s):  
Fatty Acid ◽  
Fatty Acid Binding Protein ◽  
Burn Injury ◽  
Binding Protein ◽  
The Body ◽  
Intestinal Cell ◽  
Fatty Acid Binding ◽  
Acute Period ◽  
Acid Binding Protein ◽  
Burn Disease

Introduction. Intestinal fatty acid binding protein (I-FABP) can serve as one of biomarkers of the damage to the intestinal mucosa in burned children occupying a special place among the complications and causes of their death. Materials and methods. There were examined 24 children with burns from 20% to 80% of the body surface. Blood serum I-FABP and lactate levels were determined during both the acute period of burn disease and septicotoxemia. Results. In the acute period wide variations in I-FABP values (from 22.67 to 385.18 pg/ml) were demonstrated. During the septicotoxemia I-FABP level increased by an average of 1.4 times, reflecting intestinal cell damage. Children with a burn area >40% had a higher I-FABP level during all follow-up periods compared to children with a burn ≤ 40%. In the acute period there was a positive correlation between the lactate and I-FABP levels. During the septicotoxemia, despite the increase of lactatemia and I-FABP level, this relationship was absent. The maximum increase in I-FABP level was observed in patients with complications of burn disease on the part of the intestine (duodenitis, bulbitis, stress ulcers) and with the development of sepsis. Conclusion. It seems promising to further study this biomarker in order to timely diagnose increased intestinal permeability in children with thermal trauma and develop proper treatment tactics to prevent possible complications, such as intestinal erosive and ulcerative bleeding, the development of bacterial translocation, sepsis and multi-organ failure syndrome.

scholarly journals THE PATHOGENETIC SIGNIFICANCE OF HEMOSTASIS DISORDERS DETECTION FOR THE DIAGNOSTICS AND PREVENTION OF THROMBOTIC COMPLICATIONS IN WOMEN WITH ANTENATAL FETAL DEATH

2019 ◽  
Vol 111 (3) ◽  
pp. 21-28
Author(s):  
Antonina Kotenok ◽  
Nazariy Hychka ◽  
Vasyіl Beniuk
Keyword(s):  
Pregnant Women ◽  
Fetal Death ◽  
Antithrombin Iii ◽  
Fetal Loss ◽  
The State ◽  
The Body ◽  
Reproductive Age ◽  
Thrombin Time ◽  
Case Histories ◽  
Hemostatic System

The article summarizes the arguments and counterarguments within the scientific debate on the diagnosis and prevention of disorders in hemostatic blood system in women with antenatal fetal death. The main purpose of this investigation is to study the changes in the hemostatic system in pregnant women with antenatal fetal death, namely to evaluate the features of procoagulant, anticoagulant and fibrinolytic units of the hemostatic system in women with antenatal fetal death. The systematization of literary sources and approaches to the problem of hemostatic disorders in antenatal fetal death provides an opportunity to confirm the importance of this issue, to reasonably evaluate the risks during pregnancy in each particular woman and, first of all, to prevent the occurrence of this complication. This article presents the results of a retrospective study of individual case histories of pregnant women and the case histories of childbirth of women with antenatal fetal death and physiological pregnancy in the period from 2016 to 2018. The relevance of the study of this pathology is that every fifth woman of reproductive age faces a problem such as perinatal loss. In the structure of perinatal losses, antenatal fetal death occupies a special place, which can lead to the development of fetal loss syndrome, DIC, infectious complications in the mother and infertility or subfertility in the future, which in general has a negative impact on the reproductive potential of the nation. In the course of our work we evaluated such coagulogram indicators as: prothrombin index, thrombin time, activated partial thrombin time, soluble fibrin monomer complexes, plasma fibrinogen, antithrombin III, and protein C. It is established that pregnant women with antenatal fetal death are characterized by increased blood clotting activity against the background of suppression of anticoagulant and fibrinolytic units of hemostasis. Determination of the activity of antithrombin III informs about the state of anticoagulation system of the body and provides an opportunity to adjust the treatment with anticoagulant drugs of direct action. Indicators of coagulogram canʼt fully reflect the state of hemostasis during pregnancy, so the search for new methods of early diagnosis of imbalance in the system of hemostasis during pregnancy remains relevant at this stage. These studies may be useful for gynecologists, especially in women's counseling, for the formation of risk groups for pregnant women and for preventive measures to prevent antenatal fetal death.

EPIDEMIOLOGY AND OUTCOMES OF ELECTRIC BURN INJURY AT TERTIARY CARE CENTER IN JODHPUR, RAJASTHAN

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Bharti Saraswat ◽  
Ashok Yadav ◽  
Krishna Kumar Maheshwari
Keyword(s):  
Burn Injury ◽  
Low Voltage ◽  
Care Center ◽  
Tertiary Care ◽  
The Body ◽  
Electrical Injury ◽  
Age Group ◽  
Electric Circuits ◽  
Medical College ◽  
Social Burden

Background- Electric burns and injuries are the result of electric current passing through the body. Temporary or permanent damage can occur to the skin, tissues, and major organs. Methods- This prospective study was carried out on patients admitted in burn unit of department of surgery M.G. Hospital associated with Dr. S.N. Medical College Jodhpur. Records of the patients admitted from January 2018 to December 2018 were studied. Bed head tickets of the patients evaluated in detail. Results- In our study out of 113 patients maximum no. of patients were in age group of 21-30 years 44 (38.94%) followed by age group <11 years in 21 (18.58%) patients and age group of > 60 years in only 3 (2.65%).39 (34.51%) patients were farmer and 15 (13.27%) were electrician in out of 113 total patients, while 37 (32.74%) were without any occupation. 65 (57.52%) cases of high voltage (HV) electrical injury and 48 (42.48%) cases were of low voltage (LV) electrical injury. Conclusion- Morbidity leading to permanent disabilities make the person physically dependent on others. It can be prevented by educating the people about the proper handling to electric circuits & devices. Proper communication among the electricians may help in lowering such accidents. Proper rehabilitation of the handicapped person & employment to the member of the affected family may reduce the social burden caused by such electricity concerned accidents.

On the diversity of the effects of the state support for agriculture

2019 ◽  
pp. 59-73 ◽  
Author(s):  
Nikolai M. Svetlov ◽  
Renata G. Yanbykh ◽  
Dariya A. Loginova
Keyword(s):  
Agricultural Production ◽  
The State ◽  
Russian Regions ◽  
Negative Effects ◽  
State Support ◽  
Soft Budget Constraints ◽  
Institutional Conditions ◽  
Positive Effects ◽  
Production Factors ◽  
Corporate Farms

In this paper, we assess the effects of agricultural state support of corporate farms on their revenues from agricultural production sales in 14 Russian regions that differ in technology, environment and institutional conditions. In addition to the direct effect of the state support, the indirect effects via labor and capital are revealed. For this purpose, we identify production functions and statistical models of production factors for each of these regions separately. We find out diverse effects of the state support on revenues among the regions. Positive effects prevail. Negative effects are mainly caused by labor reductions that follow subsidy inflows. Another cause of negative effects is the soft budget constraints phenomenon.

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