Significance of erythrocyte hemolysis in determining the prognosis of burn injury

Abstract

Annotation. Red blood cells are one of the first cellular structures that respond to thermal damage to the body. Thus, reactive oxygen species play an important role in the activation of complement and damage to erythrocyte cell membranes (intravascular hemolysis) during thermal injury. Based on the increased death of erythrocytes in the first days after burns, burn anemia can be observed, which, as a rule, refers to hemolytic. In severe burn shock, up to 20-30% of circulating erythrocytes are destroyed on the first day. The aim of the work is to reduce the frequency of complications of severe burn injuries in patients with erythrocyte microcirculation disorders in the capillary bed by applying an algorithm aimed at improving their architectonics and functional status. We examined 96 patients with burn injuries with a Frank index of 31–60, which consisted of 3 groups (32 patients in each), which differed in the composition of the intensive care unit: group I – treatment of patients was carried out according to the generally accepted protocol of the medical institution; group II – to the main complex of intensive care was added the appointment of a solution of ceruloplasmin intravenously, group III – in addition to the main complex of intensive care was prescribed a solution of D-fructose-1,6-diphosphate sodium salt of hydrate intravenously. The criterion for assessing the effect of treatment on the course of burn disease was to determine the level of free hemoglobin in the blood plasma, which was determined by the benzidine method. The significance of the obtained data was checked using Student’s t-test with the calculation of the Fisher Snedecor test. Data were obtained that the additional introduction of a solution of D-fructose-1,6-diphosphate sodium salt of hydrate into the complex of intensive therapy has a protective effect on the membrane of erythrocytes, promotes its stabilization, reduces the negative effect of lipid peroxidation and increases its resistance to violations of the rheological properties of blood. The appointment of this substance contributed to the acceleration of the restoration of the functional state of erythron, a decrease in the severity of intravascular hemolysis, and an improvement in the general condition of patients. Damage to erythrocyte cell membranes and impairment of functional status require further research.