Clinical guidelines for prevention, diagnostics, treatment and recovery from acute radiation injuries: classification and basic pathology

Abstract

The provision of state guarantees to citizens with medical care is achieved by compliance with clinical recommendations by medical organizations. However, acute diseases (conditions) caused by excess radiation were excluded from the relevant pathologies for the development of appropriate clinical recommendations. The current events increase the relevance of acute radiation pathology for the healthcare system and determine the high risk of such cases among the personnel of radiation-hazardous facilities and population. The necessity of developing national clinical guidelines for the prevention, diagnosis, treatment, and rehabilitation of acute radiation injury victims is substantiated. Based on an analytical review of the databases of NEB, PubMed, and Medline for 1970 to 2023 on the problem of prevention, diagnosis, treatment, and rehabilitation of individuals exposed to excess radiation and analysis of the regulatory framework governing the process of creating clinical recommendations in the Russian Federation on the provision of medical care to victims of acute radiation injuries, the main terms and their definitions relevant to acute radiation pathology were formulated, which must be unified when developing clinical recommendations. The basic classification of acute radiation lesions is presented, systematizing the variety of possible clinical forms of diseases (conditions) and their etiopathogenetic variants based on the characteristics of the types of ionizing radiation sources and individual characteristics of the conditions of acute radiation exposure. Variants of working clinical classifications of acute radiation lesions based on the generalization of the experience in the country and the world on the systematization of acute radiation pathology were determined. In general, the expediency of developing a group of clinical recommendations for the prevention, diagnosis, treatment, and rehabilitation of acute radiation injuries, covering all the various current clinical forms of diseases caused by excess (uncontrolled, unregulated, emergency) exposure, is justified. The task of determining the current list of diseases (conditions) and groups of diseases (conditions) caused by excessive human exposure in the dose range that can lead to the development of acute radiation lesions is of practical importance both for departmental medicine and the country’s healthcare system.