Preview

Messenger of ANESTHESIOLOGY AND RESUSCITATION

Advanced search

Effect of dalargin and remaxol on endocrine and metabolic disorders in patients with thoracoabdominal trauma

https://doi.org/10.21292/2078-5658-2021-18-2-69-76

Abstract

The objective: to evaluate the effect of combined use of analgesics, dalargin and tissue metabolism correctors on endocrine-metabolic disorders in patients with thoracoabdominal trauma who were injured in road accidents.

Subjects and methods. A single-center prospective randomized study was conducted in 30 victims of road accidents with thoracoabdominal trauma and traumatic shock. In 15 patients of the main group, in addition to conventional therapy, dalargin, lornoxicam were administered intravenously, and remaxol was infused.

Results. The combined use of analgesics, dalargin and correctors of tissue metabolism contributed to the maintenance of cortisol concentration at the level of compensated stress in patients of the main group, which indicated more favorable adaptive capabilities of the body.

Conclusions. Intensive therapy in patients of the main group helps to reduce the severity of anaerobic processes, optimize energy processes at the cellular level, reduce the enzymatic activity of the liver, and reduces the hospital stay of patients by 5 bed-days.

About the Authors

A. G. Miroshnichenko
I. I. Mechnikov North-Western State Medical University; Dzhanilidze St. Petersburg Research Institute of Emergency Care; Pavlov First Saint Petersburg State Medical University
Russian Federation

Aleksandr G. Miroshnichenko, Doctor of Medical Sciences, Professor, Head of Emergency Care Department

41, Kirochnaya St., St. Petersburg, 191015



R. M. Rakhmanov
V. F. Voyno-Yasenetsky State Medical University; Krasnoyarsk Interdistrict Clinical Hospital of Emergency Care Named after N. S. Karpovich
Russian Federation

Roman M. Rakhmanov,  Assistant of Department for Mobilization of Health Care,
Disaster Medicine and Emergency Care with Professional Development Training

1, Partizana Zheleznyaka St., Krasnoyarsk, 660022

17, Kurchatova St., Krasnoyarsk, Krasnoyarskiy Kray, 660062



M. A. Bolshakova
V. F. Voyno-Yasenetsky State Medical University; Krasnoyarsk Interdistrict Clinical Hospital of Emergency Care Named after N. S. Karpovich
Russian Federation

Maria A. Bolshakova, Candidate of Medical Sciences, Associate Professor of
Department for Mobilization of Health Care, Disaster Medicine and Emergency Care with Professional Development Training

1, Partizana Zheleznyaka St., Krasnoyarsk, 660022

17, Kurchatova St., Krasnoyarsk, Krasnoyarskiy Kray, 660062



A. A. Popov
V. F. Voyno-Yasenetsky State Medical University; Krasnoyarsk Interdistrict Clinical Hospital of Emergency Care Named after N. S. Karpovich; N. F. Katanov Khakass State University
Russian Federation

Andrey A. Popov, Doctor of Medical Sciences, Professor, Professor of Department
for Mobilization of Health Care, Disaster Medicine and Emergency Care with Professional Development Training

1, Partizana Zheleznyaka St., Krasnoyarsk, 660022

17, Kurchatova St., Krasnoyarsk, Krasnoyarskiy Kray, 660062

90, Lenina St., Abakan, Khakasia Republic, 655017



E. A. Popova
V. F. Voyno-Yasenetsky State Medical University; Krasnoyarsk Interdistrict Clinical Hospital of Emergency Care Named after N. S. Karpovich; N. F. Katanov Khakass State University
Russian Federation

Elena A. Popova, Doctor of Medical Sciences, Professor, Professor of Department
for Mobilization of Health Care, Disaster Medicine and Emergency Care with Professional Development Training

1, Partizana Zheleznyaka St., Krasnoyarsk, 660022

17, Kurchatova St., Krasnoyarsk, Krasnoyarskiy Kray, 660062

90, Lenina St., Abakan, Khakasia Republic, 655017



E. A. Rakhmanova
V. F. Voyno-Yasenetsky State Medical University; Krasnoyarsk Interdistrict Clinical Hospital of Emergency Care Named after N. S. Karpovich
Russian Federation

Ekaterina A. Rakhmanova, Assistant of Department for Mobilization of Health Care, Disaster Medicine and Emergency Care with Professional Development Training

1, Partizana Zheleznyaka St., Krasnoyarsk, 660022

17, Kurchatova St., Krasnoyarsk, Krasnoyarskiy Kray, 660062



D. S. Shamov
Krasnoyarsk Interdistrict Clinical Hospital of Emergency Care Named after N. S. Karpovich; N. F. Katanov Khakass State University
Russian Federation

Dmitry S. Shamov, Head of ICU no. 5

17, Kurchatova St., Krasnoyarsk, Krasnoyarskiy Kray, 660062

90, Lenina St., Abakan, Khakasia Republic, 655017



M. V. Lutsenko
Krasnoyarsk Interdistrict Clinical Hospital of Emergency Care Named after N. S. Karpovich
Russian Federation

Mikhail V. Lutsenko, Deputy Head Physician

17, Kurchatova St., Krasnoyarsk, Krasnoyarskiy Kray, 660062



O. I. Khabarova
N. F. Katanov Khakass State University
Russian Federation

Olga I. Khabarova, Candidate of Medical Sciences, Associate Professor of Surgery Department with Training in Urology, Oncology, Traumatology and Orthopedics

90, Lenina St., Abakan, Khakasia Republic, 655017



R. A. Mamedov
N. F. Katanov Khakass State University
Russian Federation

Roman A. Mamedov, Post Graduate Student of Surgery Department with Training in Urology, Oncology, Traumatology and Orthopedics

90, Lenina St., Abakan, Khakasia Republic, 655017



References

1. Bagnenko S.F., Polushin Yu.S., Miroshnichenko А.G. et al. Organizatsiya raboty statsionarnogo otdeleniya skoroy meditsinskoy pomoschi: metodicheskie rekomendatsii. [Organization of work in the in-patient emergency care: guideline]. 2nd Edition, reviewed and supplemented, Moscow, GEOTAR-Media Publ., 2018, ‒ 61 с. https://doi.org/10.25016/2541-7487-2020-0-1-05-11.

2. Belyaevskiy А.D., Lebedeva E.А., Kurtasov А.А. et al. Process of adaptation and pathological influence in development of the traumatic illness. Sovremennye Problemy Nauki i Obrazovaniya, 2012, no. 3 (In Russ.) http://science-education.ru/ru/article/view?id=6442 (Accessed: 14.01.2021).

3. Bolshakova M.А., Rakhmanova E.А., Popova E.А. et al. Metod otsenki stepeni tyazhesti postradavshikh v dorozhno-transportnykh proisshestviyakh v dogospitalnom periode, na etape priyemno-diagnosticheskogo otdeleniya gospitalnogo period. [The method for assessing the severity of road accidents victims in the pre-hospital period, admission and diagnostic department of the hospital period]. Patent no. RU 2711384 C1, 16.01.2020. Application no. 2019104825 as of 20.02.2019. https://patenton.ru/patent/RU2711384C1 (Accessed: 14.01.2021).

4. Karamyshev А.M., Ilyukevich G.V. The impact of anesthesia on the endocrine and metabolic component of the stress response during surgical treatment of congenital genitourinary malformations in children. Ekstrennaya Meditsina, 2018, vol. 7, no. 4, pp. 574-583. (In Russ.) https://rucont.ru/efd/602884.

5. Korobova L.S., Lazarev V.V., Balashova L.M. et al. Stress reactions during various anesthesia methods in ophthalmic surgery. Rossiyskiy. Vestnik Detskoy Khirurgii, Anesteziologii I Reanimatologii, 2018, vol. 8, no. 3, pp. 67-75. (In Russ.) https://doi.org/10.30946/2219-4061-2018-8-3-67-75.

6. Miroshnichenko А.G., Bolshakova M.А., Rakhmanov R.M. et al. Prospects for the use of the scale for assessing the severity of patients with isolated and concomitant trauma by an anesthesiologist-resuscitator in the anti-shock hall of the reception and diagnostic department. Skoraya Medistinskaya Pomosch, 2019, vol. 20, no. 4, pp. 44-50. (In Russ.) https://doi.org/10.24884/2072-6716-2019-20-4-44-50.

7. Edict no. 1445n by the Russian Ministry of Health as of December 24, 2012 On Approval of the Standard of Emergency Medical Care in Shock. (In Russ.) Available: https://www.rosminzdrav.ru/documents/8646.

8. Rukovodstvo po anesteziologii i reanimatologii. [Guidelines on anesthesia and critical care]. Yu.S. Polushin, eds., St. Petersburg, OOO Stiks Publ., St. Petersburg, 2004, 919 p.

9. Sorokin E.P. Changes in cortisol concentration as an indicator of the expression of stress reaction in humans with thoracoabdominal inhuries in the perioperative period. Meditsinsky Vestnik Bashkirostana, 2018, vol. 13, no. 5 (77), pp. 62-65. (In Russ.) https://www.elibrary.ru/download/elibrary_36875051_77724892.pdf.

10. Tulupov А.N., Sinenchenko G.I. Torakoabdominalnaya travma. [Thoraco-abdominal trauma]. St. Petersburg, Foliant Publ., 2015, 492 p.

11. Agrusa A., Romano G., Chianetta D. et al. Right diaphragmatic injury and lacerated liver during a penetrating abdominal trauma: case report and brief literature review. Epub.,World J. Emerg. Surg., 2014, Available: http://www.wjes.org/content/9/1/33. (Accessed: 14.01.2021), https://doi:10.1186/1749-7922-9-33. eCollection 2014.

12. Berg R.J., Karamanos E., Inaba K. et al. The persistent diagnostic challenge of thoracoabdominal stab wounds. J. Trauma Acute Care Surg., 2014, vol. 76, no. 2, pp. 418–423. https://doi:10.1097/TA.0000000000000120.

13. Caputo N., Fraser R., Paliga A. et al. Triage vital signs do not correlate with serum lactate or base deficit, and are less predictive of operative intervention in penetrating trauma patients: a prospective cohort study. Emerg. Med. J., 2013, vol. 30, no. 7, pp. 546–550, https://doi:10.1136/emermed-2012-201343.

14. Gustafson M.L., Hollosi S., Chumbe J.T. et al. The effect of ethanol on lactate and base deficit as predictors of morbidity and mortality in trauma. Amer. J. Emerg. Med., 2015, vol. 33, no. 5, pp. 607–613 https://doi:10.1016/j.ajem.2015.01.030. Epub 2015 Jan 23.

15. Huskisson E.C. Measurement of pain. Lancet, 1974, vol. 304, is. 7889, pp. 1127‒ 1131. https://doi10.1016/s0140-6736(74)90884-8.

16. Odom S.R., Howell M.D., Silva G.S. et al. Lactate clearance as a predictor of mortality in trauma patients. J. Trauma Acute Care Surg., 2013, vol. 74, is. 4, pp. 999–1004. https://doi:10.1097/TA.0b013e3182858a3e.

17. Okello M., Makobore P., Upoki A. et al. Serum lactate as a predictor of early outcomes among trauma patients in Uganda. Int. J. Emerg. Med., 2014, Epub. https://pubmed.ncbi.nlm.nih.gov/25097669/ (Accessed: 14.01.2021). https://doi:10.1186/s12245-014-0020-9.

18. Poole D., Chieregato A., Langer M.B. et al. Systematic review of the literature and evidence-based recommendations for antibiotic prophylaxis in trauma: results from an Italian Consensus of Experts. PLoS One, 2014, Available: Epub. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0113676. (Accessed: 14.01.2021), https://doi:10.1371/journal.pone.0113676.

19. Ryb G.E., Dischinger P.C., Ho S. Causation and outcomes of diaphragmatic injuries in vehicular crashes. J. Trauma Acute Care Surg., 2013, vol. 74, is. 3, pp. 835‒838. https://doi:10.1097/TA.0b013e318283d877.

20. Simsek T., Simsek H.U., Cantürk N.Z. Response to Traum and metabolic changes: posttraumatic metabolism. Ulusal. Cer. Derg., 2014, no. 30, pp. 153–159. https://doi:10.5152/UCD.2014.2653. eCollection 2014.

21. Zarour A.M., El-Menyar A., Al-Thani H. et al. Presentations and outcomes in patients with traumatic diaphragmatic injury: A 15-year experience. J. Trauma and Acute Care Surg., 2013, vol. 74, is. 6, pp. 1392‒1398. https://doi:10.1097/TA.0b013e31828c318e.


Review

For citations:


Miroshnichenko A.G., Rakhmanov R.M., Bolshakova M.A., Popov A.A., Popova E.A., Rakhmanova E.A., Shamov D.S., Lutsenko M.V., Khabarova O.I., Mamedov R.A. Effect of dalargin and remaxol on endocrine and metabolic disorders in patients with thoracoabdominal trauma. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2021;18(2):69-76. (In Russ.) https://doi.org/10.21292/2078-5658-2021-18-2-69-76



Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2078-5658 (Print)
ISSN 2541-8653 (Online)