FORMATION OF EXCESSIVE AMOUNT OF ENDOGENOUS CARBON MONOXIDE AND INCREASE OF CARBOXYLATED HEMOGLOBIN CONTENT IN...

There are serious conditions for increasing the production of endogenous carbon monoxide (CO) in patients with polytrauma. Any damage to the cell membranes under conditions of traumatic injury, shock, acute respiratory failure, destruction of the blood cells against the background of hemorrhages, blood transfusions, and blood reinfusions can contribute to the enhancement of products. The purpose of the study was the investigation of endogenous CO production in the body of patients with polytrauma by determining the percentage of carboxylated hemoglobin (HbCO%) in the blood using photoplethysmometric technology, as well as determining the degree of danger of the specified products to the body of patients. We have investigated the percentage of HbCO in the blood of 137 patients with polytrauma. 66 patients, upon admission to the clinic, showed prevailing symptoms of traumatic hypovolemic. 36 patients manifested the syndrome of acute respiratory failure on the background of a chest injury with a lung contusion. Another 35 patients had no manifestations of acute insufficiency of the systemic circulation and acute respiratory failure. The results of their survey were used for comparison. The HbCO% content was determined by a photoplethysmometric method using a Masimo Rainbow Rad-57 apparatus (USA) along with indicators of heart rate, capillary blood oxygen saturation (SpO2%) and volume peripheral capillary perfusion (perfusion index). In patients admitted to the hospital in a state of shock, all of these indicators were monitored for 24 hours from the start of urgent surgery. To determine the relationship between the severity of hemolysis and the intensity of production of endogenous CO in patients with polytrauma, 40 patients were examined for the concentration of free hemoglobin in the blood plasma using the benzidine method. The blood carboxylated hemoglobin content was found to be the greater according to the severity of shock, by definition, in accordance with the magnitude of the shock index. The maximum HbCO% blood content in patients who were in a state of shock was ascertained during reperfusion, an hour after the start of an urgent surgical intervention. In patients with thoracic injury, the content of carboxylated hemoglobin was the greater, the more severe were the manifestations of acute respiratory failure syndrome, which was detected according to the severity of arterial hypoxemia. The severity of hemolysis turned out to be an independent risk factor for increased production of endogenous CO in patients with polytrauma. The excessive production of endogenous CO in patients with polytrauma was stated to stand for an additional threat to the viability of the body due to the formation of carboxylated hemoglobin and increased hypoxia. A probable mechanism is the activation of free radical oxidation processes with the damage of cell membranes.