Method for determining suitability of preserved packed red cells for transfusion

FIELD: medicine.

SUBSTANCE: before transfusion, a preserved blood sample of 2 ml is mixed with an ozonised solution of 0.9% sodium chloride with the ozone concentration of 2 mg/l in the equivalent volume. The 15-minute exposition is followed by evaluating the 2,3 diphosphoglycerate concentration in the prepared packed red cell suspension. The 2,3 diphosphoglycerate concentration in the packed red cell suspension more than 6 mcmole/l testifies to the high effectiveness of planned hemotransfusion.

EFFECT: using the invention provides higher accuracy of determining the suitability of the preserved packed red cells for transfusion that ensures higher clinical effectiveness in the severe patients by fast and stable correction of oxygen delivery and consumption preferentially by functionally adequate red cells.

2 ex

 

The invention relates to physico-chemical methods of research of biological material and can be used in addition to determine the validity and/or willingness of canned erythrocyte mass to the transfusion.

In the basis of pathological changes that occur when severe anemia patients in critical conditions play an important role disorder delivery and elimination of oxygen and carbon dioxide tissues, which, according to literature data, often develop on the background of significant disturbances of microcirculation, activate the processes of lipid peroxidation (LPO), increasing the activity factors of endogenous intoxication (SEI) and significantly influence the outcome of intensive care unit (Akulov, MS, Maximov G.A., Levin CENTURIES the Standard of conduct of infusion-transfusion therapy and anesthesia during hemorrhagic shock // Bulletin of intensive therapy. 2005. No. 5. - P.6-8). A common method of correction of anemia severe in this situation is considered to be the transfusion of erythrocyte mass in the required amount (Chiguanco E.N., Kravets O.V. Intensive therapy blood loss. M: Medpress-inform, 2005. - 27 (C).

However, red blood cells, a significant shelf life, according to most authors, contains a small number of functionally and morphologically p is leannah erythrocytes (Polushin US Hemotransfusion - anesthesiology-reanimation view on the problem // Efferent therapy. 2004. No. 3. - P.76-86., Gavrilin SV Gerasimov GL, Boyarintsev CENTURIES Some of the contentious issues transfusion therapy in injured or // Anesthesiology and resuscitation. - 2005. No. 4. P.40-42).

Transfusion of such transfusion environment leads only to additional kalinovaya and thrombosis of the microvasculature, and deterioration thereby compromised the main pathological process gas transport function of blood.

All this testifies to the relevance of developing a method to determine the validity of erythrocyte mass when planning a blood transfusion.

The known method pretransfusion processing canned erythrocyte mass (RF patent No. 2133613, publ. 27.07.1999,, IPC AC 35/14). The known method is that the conduct perfusion of red blood cells through the column with sorbent, while transfusion of erythrocytes common retention periods additionally irradiated with light of a helium-neon laser.

According to the authors proposed a method pretransfusion processing of canned red blood cell mass can significantly improve the physico-chemical properties of red blood cells, bringing their values to the indicators swiezegowno blood.

However, the known method is e contains specific criteria, who would speak about the readiness of canned erythrocyte mass to hemotransfusion that there are no criteria that would reflect the ability of erythrocyte mass to fulfill its main gas transportation functions. In addition, the known method involves the use of special equipment (perfusion pump sets blood arteries), expensive hemosorbent and trained medical personnel, which greatly increases the cost of carrying out the transfusion.

A prototype of the invention is selected known method of determining the shelf life of canned red blood cell mass, including monitoring of indicators of erythrocyte mass (see instructions for collecting and preserving blood (Appr. The RF Ministry of health 29.05.1995).

The known method is that determine the concentration of free hemoglobin in the supernatant of erythrocyte mass after centrifugation. Increased levels of free hemoglobin in erythrocyte mass and the degree of hemolysis according to international standards should not exceed 0.8%.

However, the disadvantage of this method is lack of communication of the measured rate with the gas transport function of erythrocyte mass and low correlation of the measured parameters with the severity of anisocytosis eritria the s study of erythrocyte mass, namely, the frequency of occurrence of morphologically and functionally abnormal forms. In addition, by increasing the porosity erythrocyte membrane and reduce the activity of enzymes responsible for the transport of cations in the extracellular environment increases the concentration of potassium and sodium slowly enters the cage. By the end of the permissible period of retention level of potassium in the plasma can be increased 3-4 times or more, which is also considered as a criterion for the admissibility of transfusion (Order of Ministry of health of the Russian Federation of 25 November 2002 N363 "On approval of instruction on the use of blood components")

The task of the invention to improve the accuracy of determining the shelf life of canned erythrocyte mass to transfusion.

The problem is solved in that in the known method of determining the shelf life of canned erythrocyte mass to trasfusion, including monitoring of indicators of erythrocyte mass, prior to transfusion 2 ml samples of canned red blood cell mass is mixed with 2 ml of ozonated 0.9% sodium chloride solution with an ozone concentration of 2 mg/l after 15 minutes of exposure in the resulting erythrocyte suspensions determine the concentration of 2.3 diphosphoglycerate and at a concentration of 2.3 diphosphoglycerate in erythrocyte suspensions above 6 mmol/l appreciate canned RBC mass g is ne to conduct blood transfusion.

The present invention meets the criteria of the invention of "novelty" and "inventive step", because in the process of conducting patent information research has not identified sources of patent and scientific and medical information that would discredit the novelty of the present invention, as well as technical solutions with the essential features of the proposed method.

The proposed method allows to obtain the following effect.

The proposed method improves the accuracy of the valuation date and / or willingness of erythrocyte mass to blood transfusion, as the concentration of 2.3 diphosphoglycerate is highly specific criterion characterizing the safety of gas transmission function of transfused RBCs. The main advantage of using erythrocyte mass with pretransfusion level 2.3 diphosphoglycerate above 6 mmol/l is to increase the effectiveness of therapy anemia, including higher speed and stability correction processes himicheskogo of transport, clinically manifested in a more significant reduction in the length of hospitalization of patients in ICUs. The exclusion of transfusion plan environments pretransfusion level 2.3 diphosphoglycerate below 6 mmol/l allows to avoid transfusion functionally indefinently and rich patol the logical forms of erythrocytes and their derivatives.

The method does not require special preparation of the patient, special expensive equipment and has a relatively low cost.

The method is industrially applicable as it can be used in medical institutions public profile indicates a high efficiency of the proposed transfusion with a significant improvement in the delivery and consumption of oxygen in patients with severe anemia. The invention is aimed at increasing the effectiveness of transfusion therapy in patients with severe anemia, reduced length of stay in the intensive care unit, volume transfused transfusion environments.

The proposed method is as follows.

2 ml samples of banked blood prior to transfusion mixed with 2 ml of ozonated 0.9% sodium chloride solution with an ozone concentration of 2 mg/l After 15 minutes of exposure in the resulting erythrocyte suspensions determine the concentration of 2.3 diphosphoglycerate. At a concentration of 2.3 diphosphoglycerate in erythrocyte suspensions above 6 mmol/l indicates the date the blood Bank to conduct blood transfusion.

A specific example of implementation is given in the form of research protocols contained blood.

Protocol No. 1. Erythrocyte mass Of (I) Rh +stored 21 days, with a shelf life of 35 days canned what hemoconcentrator CFDA -1 treated with ozonized physiological solution by the proposed method. In the study, the concentration of 2,3 - FGD studied in erythrocytes initiated by the ozone concentration was 6.1 mmol/l blood transfusion to a patient with posthemorrhagic anemia severe resulted in significant growth rate of oxygen delivery 14.1%.

Protocol # 2. Erythrocyte mass Of (I) Rh-stored for 24 days, with a shelf life of 35 days preserved geoconservation CFDA -1 treated with ozonized physiological solution by the proposed method. In the study, the concentration of 2,3 - FGD studied in erythrocytes initiated by the ozone concentration was 4.7 mmol/l blood transfusion to a patient with posthemorrhagic anemia severe not resulted in significant growth rate of oxygen delivery and 12 hours after blood transfusion contributed to the decline of this indicator relative to the original level of 7.1%.

How to determine the shelf life of canned erythrocyte mass to transfusion, including monitoring of indicators of erythrocyte mass, characterized in that prior to transfusion 2 ml samples of canned red blood cell mass is mixed with 2 ml of ozonated 0.9% sodium chloride solution with an ozone concentration of 2 mg/l after 15 minutes of exposure in the resulting erythrocyte suspensions determine the concentration of 2.3 diphosphoglycerate and at a concentration of 2.3 d is phosphoglycerate in erythrocyte suspensions above 6 mmol/l appreciate canned RBC mass is suitable for carrying out the transfusion.



 

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FIELD: medicine.

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FIELD: medicine.

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FIELD: medicine.

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2 tbl, 7 ex

FIELD: medicine.

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5 ex

FIELD: medicine.

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2 ex

FIELD: agriculture.

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1 tbl, 1 ex

FIELD: medicine, pharmaceutics.

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2 cl, 9 ex

FIELD: medicine.

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1 ex

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to intensive therapy and narcology, and can be used in treatment of patients with frostbites, who are in the state of narcotic intoxication of different severity. For this purpose determined are: area of affection, degree of frostbite, degree of narcotic intoxication, physiological needs of organism and pathological loss during a day. After that, volume of infusion therapy is calculated by formula: V=(Cfs×S)+(Cn×MVDIT)+PN+PL, where: V is volume of infusion therapy, in ml; Cfs is coefficient of frostbite severity: 1.0 in case of I and II degree frostbites; 2.0 in case of III-IV severity degree frostbite; S is area of affected surface, in cm2; Cn is coefficient of narcotic intoxication severity: 1.0 - in case of changed reactivity to narcotic substance; 1.5 - in case of psychic dependence (obsessive attraction); 2.0 - in case of physical dependence (compulsive attraction); 2.5 - in case of abstinence syndrome; MVDIT is minimal volume of disinfection infusion therapy in case of application of dezomorphin, equal to 1250 ml of infusion solutions per day; PN stands for physiological needs of organism during a day; PL stands for pathological loss during a day, constituting 500 ml in case of I and II degree of frostbites and 1000 ml in case of III and IV degree of frostbites.

EFFECT: method ensures adequate and differentiated performance of infusion therapy in said category of patients taking into account degree of narcotic intoxication, which contributes to prevention of "mutual aggravation", minimisation of disorders of hemostasis, microcirculation, as well as prevention of encephalopathy of complex genesis, including carrying out necrotomy and fasciotomy.

3 ex

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to surgery and intensive therapy, and can be used in treatment of patients with frostbites. For this purpose degree of frost bite severity, area of affection, physiological needs of organism and pathological loss during a day are determined. After that, volume of infusion therapy is calculated by formula: V-C×S+PN+PL, where: V is volume of infusion therapy, in ml; C is coefficient of frost bite severity: 1.0 in case of I and II degree frostbites; 2.0 in case of III-IV degree frostbites; S is the area of affected surface, in cm2; PN stands for physiological needs of organism during a day, in ml; PL stands for pathological loss during a day, in ml.

EFFECT: method ensures elimination of hemostasis and microcirculation disorders in pre-reactive period, as well as in early and late reactive periods due to carrying out adequate infusion therapy with optimal volume of solutions.

3 ex

FIELD: medicine.

SUBSTANCE: invention relates to narcology, and can be used in treatment of patients with frost bites, who are in the state of alcoholic intoxication of different severity. For this purpose determined are: degree of frostbite, area of affection, degree of alcoholic intoxication, physiological needs of organism and pathological loss during a day. After that, volume of infusion therapy is calculated by formula: V=(CfsxS)+(CfxSVIT)+PN+PL, where: V is volume of infusion therapy, in ml; Cfs is coefficient of frost bite severity: 1.0 in case of I and II degree frost bites; 2.0 in case of III-IV severity degree frost bite; S is area of affected surface, in cm2; Ca is coefficient of alcoholic intoxication severity: 0.5 in case of mild degree, 0.75 in case of medium severity; 1.0 in case of severe degree; 1.5 - in case of alcoholic coma; SVIT is standardised volume of infusion therapy, in case of alcoholic intoxication equal 2500 ml per day: PN stands for physiological needs of organism for a day, in ml; PL stands for pathological loss within a day, in case of I and II degree frost bites constituting 500 ml; in case of III and IV degree frost bites constituting 1000 ml.

EFFECT: method ensures adequate and differentiated carrying out infusion therapy in said category of patients, taking into account degree of alcoholic intoxication, which contributes to prevention of "mutual aggravation" syndrome, minimisation of hemostasis and microcirculation, as well as prevention of encephalopathy of complex genesis, alcoholic psychosis, including cases after carrying out necrotomy and fasciotomy.

3 ex

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to resuscitation and intensive therapy and can be used in treatment of hemorrhagic shock of I, II and II degree of severity. Method of hemorrhagic shock treatment. For this purpose, assessment of degree of hemorrhagic shock severity is carried out, and in case of hemorrhagic shock of 1 degree of severity in the programme of infusion therapy included are: crystalloid solution of isotopic sterofundin in dose 3000 ml per day and 4% colloidal solution of modified gelatin in volume 1000 ml per day, in case of hemorrhagic shock of II degree of severity - 1200 and 2500 ml respectively, in case of hemorrhagic shock of III degree of severity - 1200 and 3500 ml respectively.

EFFECT: method makes it possible to improve results of treating patients with hemorrhagic shock at pre-hospital and hospital stages due to reduction of risk of electrolyte and acid-alkaline disorders.

1 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely resuscitation and may be used for prevention of severe complications in surgical management of massive and submassive blood loss with continuous haemorrhages. That is ensured by the intraoperative intravenous drop-by-drop introduction of Perftoran 2-4 ml/kg following mechanical arrest of the continuous haemorrhages. With underlying restorable blood volume, higher body oxygenation with eliminated nitrogen oxide inhalation. Rheamberyn is introduced in an average therapeutic dose at the end of the operation and on the first three postoperative days.

EFFECT: invention provides higher effectiveness of infusion-transfusion management, improved clinical course of the operative and postoperative period, reduced percentage of complications and mortality.

2 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine. What is prescribed is taking a beverage made of soluble granulated magnolia-vine extract. The beverage 250 ml is taken before a dip for 20 days three times a day.

EFFECT: use of the declared method enables unfavourable changes of water and electrolyte metabolism in divers.

1 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine. What is prescribed is a beverage made of soluble granulated magnolia-vine extract. The beverage 250 ml is taken before a dip (compression in a vacuum chamber) for 20 days three times a day.

EFFECT: method is high-effective for prevention of compressed-air disease in divers.

1 ex

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention refers to medicine and pharmacology and represents the use of water-soluble hybrid macromolecular compounds: O-(3-(3,5-di-tert-butyl-4-hydroxyphenyl)propionyl)-(1→6)-α-D-glucan, polyethylene glycol bis-3-(3,5-di-tert-butyl-4-hydroxyphenyl)-propionate as agents improving survival rate in wound shock.

EFFECT: invention provides the extended range of products applied in therapy for wound shock.

4 ex, 1 tbl

FIELD: medicine.

SUBSTANCE: invention refers to medicine, and may be used for the individual's functional state correction. That is ensured by diagnosing the functional state followed by correcting the detected disorders. Blood pH is determined when diagnosing the functional state. For the purpose of correcting the detected disorders, the conventional treatment is combined with administering a solution heated to a temperature of 36.6°C, prepared by an electrolytic reduction of a saline solution to form an anolyte and a catholyte to be mixed to prepare a solution of pH 2-10 and an oxidation-reduction potential within +1050 to -800 mV; the solution is administered into the patient to provide blood pH within 7.35-7.45.

EFFECT: invention provides the adequate individual's functional state correction in the presence of a chronic infection by the effect of an activated medium on an acid-base balance of blood and the individual's oxidation-reduction potential (ORP).

2 cl, 4 ex

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