rmtОбщая реаниматологияGeneral Reanimatology1813-97792411-7110FSBI "SRIGR" RAMS10.15360/1813-9779-2020-6-4-18rmt-1983Research ArticleКЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯ И ПРАКТИКАCLINICAL STUDIES AND PRACTICEГипербарическая оксигенация в терапии пациентов с COVID-19Hyperbaric Oxygen Therapy in Patients with COVID-19ПетриковС. С.PetrikovS. S.

129090, Москва, Большая Сухаревская пл., д. 3

Sergey S. Petrikov

3 Bolshaya Sukharevskaya Square, 129090 Moscow

ЕвсеевА. К.EvseevA. K.

Анатолий Константинович Евсеев

129090, Москва, Большая Сухаревская пл., д. 3

Anatoly K. Evseev

3 Bolshaya Sukharevskaya Square, 129090 Moscow

evseevak@sklif.mos.ruЛевинаО. А.LevinaO. A.

129090, Москва, Большая Сухаревская пл., д. 3

Olga A. Levina

3 Bolshaya Sukharevskaya Square, 129090 Moscow

ШабановА. К.ShabanovA. K.

129090, Москва, Большая Сухаревская пл., д. 3

Aslan K. Shabanov

3 Bolshaya Sukharevskaya Square, 129090 Moscow

КулабуховВ. В.KulabukhovV. V.

129090, Москва, Большая Сухаревская пл., д. 3

Vladimir V. Kulabukhov

3 Bolshaya Sukharevskaya Square, 129090 Moscow

КутровскаяН. Ю.KutrovskayaN. Yu.

129090, Москва, Большая Сухаревская пл., д. 3

Natalia Yu. Kutrovskaya

3 Bolshaya Sukharevskaya Square, 129090 Moscow

БоровковаН. В.BorovkovaN. V.

129090, Москва, Большая Сухаревская пл., д. 3

Natalia V. Borovkova

3 Bolshaya Sukharevskaya Square, 129090 Moscow

КлычниковаЕ. В.KlychnikovaЕ. V.

129090, Москва, Большая Сухаревская пл., д. 3

Elena V. Klychnikova

3 Bolshaya Sukharevskaya Square, 129090 Moscow

ГорончаровскаяИ. В.GoroncharovskayaI. V.

129090, Москва, Большая Сухаревская пл., д. 3

Irina V. Goroncharovskaya

3 Bolshaya Sukharevskaya Square, 129090 Moscow

ТазинаЕ. В.TazinaE. V.

129090, Москва, Большая Сухаревская пл., д. 3

Elizaveta V. Tazina

3 Bolshaya Sukharevskaya Square, 129090 Moscow

ПопугаевК. А.PopugaevK. А.

129090, Москва, Большая Сухаревская пл., д. 3

Konstantin A. Popugaev

3 Bolshaya Sukharevskaya Square, 129090 Moscow

КосолаповД. А.KosolapovD. A.

129090, Москва, Большая Сухаревская пл., д. 3

Denis A. Kosolapov

3 Bolshaya Sukharevskaya Square, 129090 Moscow

СлободенюкД. С.SlobodeniukD. S.

129090, Москва, Большая Сухаревская пл., д. 3

Daria S. Slobodeniuk

3 Bolshaya Sukharevskaya Square, 129090 Moscow

НИИ скорой помощи им. Н.В. СклифосовскогоРоссияN.V. Sklifosovsky Research Institute for Emergency MedicineRussian Federation202030122020166418Copyright © Петриков С.С., Евсеев А.К., Левина О.А., Шабанов А.К., Кулабухов В.В., Кутровская Н.Ю., Боровкова Н.В., Клычникова Е.В., Горончаровская И.В., Тазина Е.В., Попугаев К.А., Косолапов Д.А., Слободенюк Д.С., 20202020Петриков С.С., Евсеев А.К., Левина О.А., Шабанов А.К., Кулабухов В.В., Кутровская Н.Ю., Боровкова Н.В., Клычникова Е.В., Горончаровская И.В., Тазина Е.В., Попугаев К.А., Косолапов Д.А., Слободенюк Д.С.Petrikov S.S., Evseev A.K., Levina O.A., Shabanov A.K., Kulabukhov V.V., Kutrovskaya N.Y., Borovkova N.V., Klychnikova Е.V., Goroncharovskaya I.V., Tazina E.V., Popugaev K.А., Kosolapov D.A., Slobodeniuk D.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.reanimatology.com/rmt/article/view/1983Цель исследования

Цель исследования: изучение эффективности гипербарической оксигенотерапии и ее влияния на показатели окислительного стресса и апоптоза у пациентов с новой коронавирусной инфекцией COVID-19.

Материалы и методы

Материалы и методы. Обследовали 90 пациентов с диагнозом новая коронавирусная инфекция, вызванная вирусом SARS-CoV-2. Курсы гипербарической оксигенотерапии проводили у 57 человек (38 в тяжелом состоянии (КТ 3-4), 19 в состоянии средней тяжести (КТ 1-2)). Процедуры осуществляли при режиме 1,4-1,6 АТА в течение 40 минут, всего провели 247 сеансов. Влияние гипербарической оксигенации (ГБО) оценивали на основании измерения уровня насыщения гемоглобина кислородом, выраженности окислительного стресса и апоптоза лимфоцитов крови.

Результаты

Результаты. У всех обследованных пациентов на фоне проведения курса ГБО отметили положительную динамику в виде уменьшения одышки и улучшения общего самочувствия. Уровень насыщения гемоглобина кислородом после окончания курса ГБО составлял 95,0±1,6% (до проведения курса — 91,3±5,9%), что позволило перевести практически всех пациентов на спонтанное дыхание без необходимости дальнейшей оксигенотерапии. Проведение ГБО не вызывало снижения общей антиоксидантной активности, однако приводило к снижению концентрации малонового диальдегида с 4,34±0,52 мкмоль/л до 3,98±0,48 мкмоль/л и величины потенциала при разомкнутой цепи платинового электрода с -22,78±24,58 мВ до -37,69±17,4 мВ. Кроме того, положительное влияние ГБО выражалось в нормализации процессов апоптоза клеток крови.

Заключение

Заключение. ГБО у пациентов с новой коронавирусной инфекцией, вызванной вирусом SARS-CoV-2, является эффективным методом и оказывает мультифакторное действие, приводящее как к улучшению субъективных показателей состояния обследованных пациентов, так и к повышению насыщения гемоглобина кислородом, снижению интенсивности процессов перекисного окисления липидов, активации антиоксидантной системы организма, восстановлению баланса про- и антиоксидантов, нормализации процессов апоптоза.

The aim of the study is to evaluate the efficacy of hyperbaric oxygen therapy and its effect on oxidative stress and apoptosis in patients with new coronavirus infection COVID-19.

Materials and methods

Materials and methods. 90 patients diagnosed with new coronavirus infection caused by SARS-CoV-2 virus were examined. Hyperbaric oxygen therapy sessions were conducted in 57 patients (38 in severe condition (CT 3-4), 19 in moderate condition (CT 1-2)). The procedures were performed in 1.4-1.6 ATA mode for 40 minutes, 247 sessions in total were performed. The effect of hyperbaric oxygenation was assessed by measuring the level of oxygen saturation, the severity of oxidative stress and apoptosis of blood lymphocytes.

Results

Results. In all examined patients with new coronavirus infection caused by SARS-CoV-2, positive changes such as dyspnea reduction and improvement of general well-being were registered after hyperbaric oxygen therapy sessions. The level of oxygen saturation after the end of the hyperbaric oxygen therapy course was 95.0±1.6% (before the course — 91.3±5.9%), which allowed to return almost all patients to spontaneous respiration without the need for further oxygenation therapy. Hyperbaric oxygen therapy did not reduce the total antioxidant activity, however, it was associated with a decrease in the blood malone dialdehyde from 4.34±0.52 pmol/l to 3.98±0.48 pmol/l and a decrease in open circuit potential of platinum electrode from -22.78±24.58 mV to -37.69±17.4 mV. Besides, the positive effect of hyperbaric oxygen therapy was manifested in normalization of blood cell apoptosis.

Conclusion

Conclusion. Hyperbaric oxygen therapy in patients with new coronavirus infection caused by the SARS-CoV-2 virus is an effective treatment method with multiple effects resulting in improvement of subjective indicators of the patients' condition, increase of hemoglobin oxygen saturation, decrease of lipid peroxidation intensity, activation of antioxidant system, restoration of pro- and antioxidant balance and apoptosis normalization.

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The authors declare that there are no conflicts of interest present.