nmpЖурнал им. Н.В. Склифосовского «Неотложная медицинская помощь»Russian Sklifosovsky Journal "Emergency Medical Care"2223-90222541-8017“N.V. Sklifosovsky Research Institute for Emergency Medicine”10.23934/2223-9022-2020-9-3-314-320nmp-923Research ArticleНОВОЕ О COVID-19NEW ABOUT COVID-19Безопасность применения гипербарической оксигенации при лечении COVID-19The Safety of Hyperbaric Oxygen Therapy in the Treatment of Covid-19https://orcid.org/0000-0002-4811-0845ЛевинаО. А.LevinaO. A.

Левина Ольга Аркадьевна кандидат медицинских наук, ведущий научный сотрудник клиники неотложной нейрохирургии

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

Olga A. Levina Candidate of Medical Sciences, Leading Researcher of the Clinic of Emergency Neurosurgery

3 Bolshaya Sukharevskaya Square, Moscow 129090

levina_olga@bk.ruhttps://orcid.org/0000-0002-0832-3272ЕвсеевА. К.ЕvseevA. K.

Евсеев Анатолий Константинович доктор химических наук, ведущий научный сотрудник отделения общей реанимации

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

Anatoly K. Evseev Doctor of Chemistry, Leading Researcher of the General Resuscitation Department

3 Bolshaya Sukharevskaya Square, Moscow 129090

anatolevseev@gmail.comhttps://orcid.org/0000-0002-3417-2682ШабановА. К.ShabanovA. K.

Шабанов Аслан Курбанович доктор медицинских наук, старший научный сотрудник отделения общей реанимации

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

Aslan K. Shabanov Doctor of Medical Sciences, Senior Researcher at the General Resuscitation Department

3 Bolshaya Sukharevskaya Square, Moscow 129090

aslan_s@mail.ruhttps://orcid.org/0000-0003-1769-7038КулабуховВ. В.KulabukhovV. V.

Кулабухов Владимир Витальевич кандидат медицинских наук, ведущий научный сотрудник отделения неотложной хирургии, эндоскопии и интенсивной терапии

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

Vladimir V. Kulabukhov Candidate of Medical Sciences, Leading Researcher at the Department of Emergency Surgery, Endoscopy and Intensive Care

3 Bolshaya Sukharevskaya Square, Moscow 129090

kulabuchovvv@sklif.mos.ruhttps://orcid.org/0000-0002-3202-570XКутровскаяН. Ю.KutrovskayaN. Y.

Кутровская Наталья Юрьевна кандидат медицинских наук, врач-офтальмолог отделения неотложной нейрохирургии

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

Natalya Y. Kutrovskaya Candidate of Medical Sciences, Ophthalmologist of the Department of Emergency Neurosurgery

3 Bolshaya Sukharevskaya Square, Moscow 129090

kutrovskaya.natalia@yandex.ruhttps://orcid.org/0000-0003-0113-306XГорончаровскаяИ. В.GoroncharovskayaI. V.

Горончаровская Ирина Викторовна кандидат химических наук, старший научный сотрудник отделения общей реанимации

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

Irina V. Goroncharovskaya Candidate of Chemistry Sciences, Senior Researcher of the General Resuscitation Department

3 Bolshaya Sukharevskaya Square, Moscow 129090

goririna22@gmail.comhttps://orcid.org/0000-0002-6240-820XПопугаевК. А.PopugaevK. A.

Попугаев Константин Александрович доктор медицинских наук, заместитель директора — руководитель регионального сосудистого центра

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

Konstantin A. Popugaev Doctor of Medical Sciences, Deputy Director – Head of the Regional Vascular Center

3 Bolshaya Sukharevskaya Square, Moscow 129090

popugaevka@sklif.mos.ruhttps://orcid.org/0000-0002-6655-1273КосолаповД. А.KosolapovD. A.

Косолапов Денис Александрович кандидат медицинских наук, заведующий отделением реанимации и интенсивной терапии для кардиохирургических больных

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

Denis A. Kosolapov Candidate of Medical Sciences, Head of the Department of Resuscitation and Intensive Care for Cardiac Surgery Patients

3 Bolshaya Sukharevskaya Square, Moscow 129090

kosolapovda@sklif.mos.ruСлободенюкД. С.SlobodeniukD. S.

Слободенюк Дарья Сергеевна врач анестезиолог-реаниматолог отделения общей реанимации

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

Daria S. Slobodeniuk Anesthesiologist and intensive care physician of the General Resuscitation Department

3 Bolshaya Sukharevskaya Square, Moscow 129090

fdashka@mail.ruhttps://orcid.org/0000-0003-3292-8789ПетриковС. С.PetrikovS. S.

Петриков Сергей Сергеевич член-корреспондент РАН, доктор медицинских наук, директор

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

Sergei S. Petrikov Corresponding Member of the Russian Academy of Sciences, Doctor of Medical Sciences, Director

3 Bolshaya Sukharevskaya Square, Moscow 129090

petrikovss@sklif.mos.ruОтделение общей реанимации ГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского ДЗМ»РоссияGeneral Resuscitation Department N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health DepartmentRussian Federation20202110202093314320Copyright © Левина О.А., Евсеев А.К., Шабанов А.К., Кулабухов В.В., Кутровская Н.Ю., Горончаровская И.В., Попугаев К.А., Косолапов Д.А., Слободенюк Д.С., Петриков С.С., 20202020Левина О.А., Евсеев А.К., Шабанов А.К., Кулабухов В.В., Кутровская Н.Ю., Горончаровская И.В., Попугаев К.А., Косолапов Д.А., Слободенюк Д.С., Петриков С.С.Levina O.A., Еvseev A.K., Shabanov A.K., Kulabukhov V.V., Kutrovskaya N.Y., Goroncharovskaya I.V., Popugaev K.A., Kosolapov D.A., Slobodeniuk D.S., Petrikov S.S.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jnmp.ru/jour/article/view/923Актуальность

Актуальность. Острая респираторная инфекция COVID-19, вызываемая коронавирусом SARS-CoV-2 (2019-nCov), в 15–20% случаев протекает в тяжелой и крайне тяжелой степени, что сопровождается необходимостью респираторной поддержки. Гипербарическая оксигенация признана эффективным средством терапии, восполняющим любые формы кислородной задолженности.

Цель работы

Цель работы. Исследование безопасности применения гипербарической оксигенации (ГБО) у пациентов с COVID-19.

Материал и методы

Материал и методы. Были обследованы 32 пациента с диагнозом «Коронавирусная инфекция, вызванная вирусом SARS-CoV-2» (10 — больные средней тяжести (КТ 1–2), 22 — больные в тяжелом состоянии (КТ 3–4)), которым был назначен курс гипербарической оксигенации (ГБО). Процедуры осуществляли в реанимационной барокамере Sechrist 2800 (CША) при режиме 1,4–1,6 АТА в течение не более 60 минут. Всего пациенты получили 141 сеанс ГБО. До и после каждого сеанса ГБО оценивали субъективные показатели состояния пациентов и измеряли насыщение крови кислородом.

Результаты исследования

Результаты исследования. Был разработан алгоритм ведения курса ГБО, заключающийся в использовании при первом сеансе «мягких» режимов (до 1,4 АТА) с последующей корректировкой давления (не выше 1,6 АТА) в течение курса для достижения максимального терапевтического эффекта и комфорта для пациента. На фоне проведения курса ГБО у пациентов было отмечено повышение насыщения кислородом крови у пациентов в обеих обследованных группах, а также положительная динамика в виде уменьшения одышки улучшения общего самочувствия.

Заключение

Заключение. Включение в комплексную терапию при COVID-19 ежедневных сеансов (не менее 4) гипербарической оксигенации в «мягких» режимах (1,4–1,6 АТА) показало свою безопасность и предварительный положительный эффект на субъективное состояние обследованных пациентов и динамику насыщения крови кислородом.

Relevance

Relevance. Acute respiratory infection COVID-19 caused by the SARS-CoV-2 (2019-nCov) coronavirus is severe and extremely severe in 15—20% of cases, which is accompanied by the need for respiratory support. Hyperbaric oxygenation is recognized as an effective therapy for replenishing any form of oxygen debt.

Aim of study

Aim of study. To study the safety of HBO use in patients with COVID-19.

Material and metods

Material and metods. We examined 32 patients with the diagnosis “Coronavirus infection caused by the virus SARS-CoV-2” (10 — moderately severe patients (CT 1–2), 22 — patients in serious condition (CT 3–4), who received course of hyperbaric oxygenation (HBO). The procedures were carried out in a Sechrist 2800 chamber (USA) at a mode of 1.4–1.6 AT for no more than 60 minutes. In total, the patients received 141 HBO sessions. Before and after each HBO session, the subjective indicators of the patient’s condition were assessed and the blood oxygen saturation was measured.

Results

Results. An algorithm for HBO course management was developed, which consists in using “soft” modes (up to 1.4 AT) during the first session, followed by pressure adjustment (not higher than 1.6 AT) during the course to achieve maximum therapeutic effect and comfort for the patient. Against the background of the HBO course, the patients showed an increase in blood oxygen saturation in patients in both surveyed groups, as well as positive dynamics in the form of a decrease in shortness of breath, an improvement in general well-being.

Conclusion

Conclusion. The inclusion of daily sessions (at least 4) of hyperbaric oxygenation in “soft” modes (1.4–1.6 ATA) in the complex therapy for COVID-19 has shown its safety and preliminary positive effect on the subjective state of the examined patients and the dynamics of blood oxygen saturation.

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