Purpose. To assess changes in the degree of pulmonary injury in patients with Sars-CoV-2 after extracorporeal hemocorrection methods (ECHCM).Material and methods. 27 patients with Sars-CoV-2 underwent 48 ECHCM procedures - plasma separation, nonselective cytosorption hemoperfusion, dialysis-filtration techniques. After arriving in the hospital all patients underwent MSCT of the chest organs. The examination was conducted according to the standard protocol of MSCT of the chest organs and reconstruction of soft and high-resolution on a Philips Ingenuity CT 64 multi- detector computed tomograph. The following scanning parameters were used for the standard protocol: 64 × 0.625 collimation, 1 mm reconstruction, 0.5 mm increment. The patient was lying on his back with his arms thrown back behind his head during the procedure. A scan area including the chest was planned by the plan scan. Assessment of the scans was carried out in the Diсom-images viewing module of medical hardware- software complex “ArchiMed” (Med-Ray. Russia, 2004). The percentage of lung parenchyma lesions as well as the severity (CT-1–4) were evaluated according to the recommendations “Radiation diagnosis of coronavirus disease (COVID-19): organization, methodology, interpretation of the results”. CT examinations were compared not earlier than 4 days before ECHCM and not later than 5 days after.Result. With isolated plasmaseparation, the “ground glass” zones passed into the consolidation zones, the total volume of the lesion decreased and the pneumatization increased. In isolated hemoperfusion the dynamics is multidirectional: there are more consolidation zones, less ground glass zones in general, the process is stabilized and the zones of lung tissue damage are reduced. With isolated hemodiafiltration, the consolidation zones decreased, the pneumatization of the lung tissue increased, and subsequently the volume of the lesion and the consolidation zones increased significantly. By combined procedures there are multidirectional dynamics.Conclusion. The effect of ECMGC use on the degree and volume of lung tissue damage in patients with Sars- CoV-2 was not revealed.
Ми проаналізували 45-денний досвід роботи в COVID-лікарні на базі хірургічного центру. Більше 30% пацієнтів потребували ШВЛ. Найбільш важкі пацієнти старше 80 років (13,5%) та з ІМТ> 40 кг / м 2 (21,8%). При лікуванні використовувалися рекомендації МОЗ РФ. 17,9% пацієнтів отримували неінвазивну штучну вентиляцію легенів (NIMV), 33,9%-високопоточних назальний кисневу терапію (HFNOT). 69% були переведені на механічну вентиляцію, з них 19,8%-шляхом накладення трахеостоми. Госпітальна летальність склала 4,8%. (жінки 55%, чоловіки 45%, пацієнти з ожирінням-36,8%, пацієнти старечого віку-45% від усіх летальних випадків). Продемонстрували ефективність послідовне використання різних методів лікування респіраторних захворювань, методів «fast track» при МВ і використання екстракорпоральних методів лікування «цитокинового шторму».
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.