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The Effect of Chronic Heart Failure on Hemic Parameters during Polytrauma

The purpose of the study was to carry out the examination of hemic indicators in patients during polytrauma with chronic heart failure without acute myocardium injury using ethylmethylhydroxypyridine succinate. Materials and methods. The study included 96 patients in the polytrauma department. Patients were divided into 3 groups. The first group included 29 patients of the control group (C) aged 58.7±9.4 years. Group C patients showed no signs of chronic heart failure. The second group of standard (S) included 33 patients with the same injuries, but with confirmed chronic heart failure aged 60.0±9.6 years. Group C patients received intensive care according to the local protocol developed in accordance with the protocol of the Ministry of Healthcare of Ukraine. The third group E included 33 patients aged 62.8±8.8 years who received ethylmethylhydroxypyridine succinate during intensive care. Group E patients differed from patients of group S only by receiving ethylmethylhydroxypyridine succinate. Results and discussion. The concentration of hemoglobin of group C patients during admission is 99.9±22.1 g/l, on the 3rd day – 100.3±15.0 g/l, on the 7th day – 111.1±9.2 g/l. The hemoglobin saturation of arterial blood (SaO2) during admission in group C was 0.93±0.03, on the 3rd day – 0.96±0.02 (p <0.001), and on the 7th day – up to 0.97±0.01 (p <0.001). The hemoglobin saturation of venous blood (SvO2): within admission – 0.70±0.04, on the 3rd day – 0.73±0.02 (p <0.001), on the 7th day – 0.77±0.02 (p <0.001). The oxygen tension dissolved in arterial blood (PaO2) during admission of group C patients is 86.9±4.1 mm Hg, on the 3rd day – 89.2±3.2, on the 7th day – 91.6±2.8 mm Hg. The oxygen tension dissolved in venous blood (PvO2) was 37.3±1.2, 38.9±0.7 and 40.0±0.6 mm Hg, according to the stages of the study. The hemoglobin concentration of group S patients was 109.7±23.3 g/l, then decreased to 100.7±10.4 g/l (p <0.05), and on the 7th day – 107.6±10.1 g/l (p >0.1 compared to the initial level). SaO2 during admission of group S was 0.92±0.03, on the 3rd day – 0.95±0.02 (p <0.001), on the 7th day – 0.96±0.03 (p >0.6). SvO2 was 0.68±0.03, 0.72±0.02 (p <0.001) and 0.73±0.03, respectively at the study stages. PaO2 within admission of group C patients amounted to 82.4±3.5, 89.2±3.6 (p <0.001) and 90.4±4.8 mm Hg. PvO2 was 36.8±1.0, 38.5±0.7 and 39.2±1.2 mm Hg in accordance with the research stages. The hemoglobin concentration during admission of group E patients was 110.2±24.6 g/l, on the 3rd day – 100.0±28.8 g/l, on the 7th day – 113.4±27.2 g/l. SaO2 during admission of group E was 0.92±0.03, on the 3rd day – 0.97±0.02 (p <0.001), did not change until the end of the study. SvO2 during admission was 0.68±0.05, on the 3rd day – 0.73±0.02 (p <0.001), on the 7th day – 0.75±0.02 (p <0.04). PaO2 during admission of group E patients was 82.5±3.6 mm Hg, on the 3rd day – 90.3±5.0 mm Hg (p <0.001), on the 7th day 90.9±5.8 mm Hg (p >0.6). The PvO2 dynamics was 36.5±0.6, 39.0±0.6 and 39.1±0.6 mm Hg in accordance with the research stages. Conclusion. Hemoglobin level and blood gas indicators reflect a close relationship with chronic heart failure. Therefore, it is clear that these indicators level tends to increase especially on the 7th day. It can be concluded that ethylmethylhydroxypyridine succinate has a cumulative action