Course Of Inhalation Research Articles

Application of haloinhalations at the sanatorium-resort stage of rehabilitation of patients after COVID-19.

After suffering from COVID-19, a large number of patients need respiratory rehabilitation. One of the methods of rehabilitation is inhalation with salt aerosols. Our work aimed to study the effectiveness of inhalations of a dry aerosol of salt precipitated from the mineral water of the "Teplitsa multidisciplinary sanatorium", Transcarpathian region of Ukraine. 30 male patients were examined after suffering from COVID-19. We formed two groups of patients, control and main, 15 people each. Patients in the control group received inhalation with a dry aerosol of table salt of the "Aero-M-sol". In contrast, patients in the main group received a course of inhalations with a dry aerosol of salt precipitated from the mineral water. Under the influence of the rehabilitation complex in both groups, there is a performance improvement but significant changes are observed only in patients of the main group. The indicator Forced Vital Сapacity1 increased to the greatest extent, which after rehabilitation is significantly higher than in the control group (p<0.05). As a result, the Tiffeneau index significantly increases in the main group compared to the control group, reaching normal values. The main effect is associated with a decrease in obstructive complications of the respiratory tract as a result of a decrease in inflammation. The use of iodine-bromine brines (as in our case) for inhalation in the treatment of respiratory diseases has been proven to be effective, with systemic effects in the form of decreased IgE and increased IgA in the blood serum having been noticed. The use of haloinhalations with MW salts in the rehabilitation of patients after suffering from COVID-19 disease significantly improves the clinical condition of convalescents.

Обгрунтування респіраторної цитопротекції при бронхіальній астмі у дітей

Abstract. The aim of the study. To improve the results of treatment and prevention measures for bronchial asthma (BA) in children by supplementing the complex of basic therapy with the inhalation of the drug еctoin ("Ectobris"). Material and methods. A comprehensive clinical and paraclinical examination of 78 school-aged children with BA was conducted. 2 clinical groups were formed. The first group was formed by 47 children (average age — (12.2 ± 0.5) years, the share of boys — 78.7 %), who received standard basic treatment for BA. The II group included 31 patients with BA (average age — (11.7 ± 0.6) years, p &gt; 0.05, the proportion of boys — 67.7 % (p &gt; 0.05)), whose basic therapy included the inhalation drug "Ektobris" (2.5 ml in containers for nebulization 2 times/day for 10 days). The main clinical characteristics of the observation groups were comparable. Results. We established that children with asthma who received Ectobris inhalations in complex basic treatment had an increase in the average score on the ACT questionnaire, which indicated an improvement in disease control (increase in absolute risk (AR) — 53.8 %, increase in relative risk (RR) — 69.9 % (95%CI: 59.9-78.7) with the minimum number of patients (MNP) — 1.4 (95%CI: 0.04-6.5). It was also shown that the use of the 10-day course of inhalations was accompanied by a decrease in inflammatory desquamation of the epithelium (according to nasocytogram data), and an increase in the chances of achieving the minimum number of desquamated epitheliocytes (&lt; 5 %) in the nasal epithelium was characterized by: DAR — 32.0 %, DRR — 52, 4% (95%CI: 42.2-62.5), MNP — 1.9 (95%CI: 0.1-7.2) and also made it possible to reduce the indicators of nonspecific hypersensitivity of the respiratory tract to indirect bronchospasmogenic factors. Conclusions. Adding "Ektobris" inhalations to the standard basic anti-inflammatory therapy of BA made it possible to improve control over the asthma, reduce indicators of non-specific hypersensitivity of the respiratory tract to physical exertion.

EXPERIMENTAL STUDY OF ERYTHROCYTE ENERGY METABOLISM UNDER INHALATIONS OF NITRIC OXIDE

Abstract Biological effects of nitric oxide are multiply, including vasoactive activity, participation in neurotransmission and intercellular communication etc. These effects are associated with endogenous releasing of nitric oxide, but influence of exogenous administration of this substance does not study in details. In particular, systemic action of nitric oxide inhalations is not so clear. The aim of this work was the investigation of nitric oxide inhalations action on some parameters of energy and oxidative metabolism of healthy rat blood. Wistar rats were randomly divided into two groups: control group (without any manipulations; n=10) and main group (n=10) with inhalations by nitric oxide-containing gas flow (20 ppm). Lactate dehydrogenase and lactate level were estimated in rat blood samples. In addition, we calculated a number of integral coefficients of energy metabolism, such as substrate provision coefficient and coefficient of energy reactions balance. Our experiments demonstrate that 10-days course of inhalations of low nitric oxide doses (20 ppm) increases the adaptive potential of healthy rats’ organism. One of these positive effects is associated with activation of some components of energy metabolism. First of all, it realized through stimulation of catalytic activity of lactate dehydrogenase, including its erythrocyte pool. Observed metabolic effect provides the basis for pathogenic correction of diseases, associated with hypoxia, oxidative stress and energy deficiency.

Mineral water inhalations for bronchial asthma: a meta-analysis.

Bronchial asthma (BA) is a common disease that contributes significantly to the incidence rate and death rate worldwide. A widespread treatment method is the use of inhalations of mineral waters, with conflicting information about their effectiveness. Purpose of the study was to assess the generalized effect power of the course of inhalations of mineral waters on the disease progress in patients with BA. A search of randomized clinical studies in data bases Pubmed, EMBASE, ELibrary, MedPilot amd CyberLeninka, according to PRISMA strategy, published between 1986 and July 2021. Standardized difference of mean values and their 95% of CI were employed for calculation using the random effects model. The meta-analysis drawing on 1266 sources included 14 studies, with 2 of them being randomized controlled clinical studies, including the results of the treatment of 525 patients. All 14 articles contain a conclusion that the inhalation of mineral water has a positive effect on the course of the disease in patients with BA. The analysis demonstrated that the group of patients after mineral water inhalations, compared with the control group, showed improvement of forced expiratory volume (FEV1), expressed both in % of the norm and in liters. The standardized difference of mean values FEV1 (%) (Hedge's g) was 8.2 (95% CI: 5.87 - 10.59; 100%), FEV1 values (liter.) (Hedge's g) was 0.69 (95% CI: -0.33-1.05). A significant heterogeneity of the results of individual studies was found (Q=124.96; tau2 = 14.55, I2 = 69.13%, p<0.0001 and Q=2.35; tau2 = 0, I2 = 0%, p<0.0001). Patients with mild, moderate, and hormone-dependent BA with a controlled and partially controlled disease course, after mineral water inhalations, compared with the control group, demonstrated a statistically significant decrease in the frequency and intensity of the cardinal symptoms of BA and improvement of FEV1.

Clinical case of nebulized surfactant therapy for severe COVID-19-associated pneumonia at the 2nd stage of rehabilitation treatment

The development of an effective and safe drug for the treatment of patients with COVID-19 is currently an urgent task for the global medical community. Given that lung damage remains the predominant syndrome in COVID-19, and the development of acute respiratory distress syndrome (ARDS) is the most common reason for transfer to intensive care unit and connection to artificial lung ventilation, it seems promising to study the effectiveness and safety of surfactant therapy, successfully proven in practice in the treatment of adult and preterm infants ARDS. Despite the fact that most studies are devoted to the use of this method in patients in the acute stage, we present a case from our own practice of Surfactant-BL inhalation in a patient with COVID-19-associated pneumonia at the 2nd stage of rehabilitation treatment. Clinical signs of respiratory failure (RR 22 per minute, Sa O2 86% on atmospheric air, 95% on insufflation of humidified oxygen 7 L/min), high percentage of lung tissue damage according to thoracic CT (55% – CT3) on admission to the Medical Rehabilitation Unit, as well as a score of 6 on the NEWS2 scale served as a basis for the patient to receive Surfactant-BL inhalation for the indication «prevention of the development of acute respiratory distress syndrome» in a dosage of 75 mg twice a day for 5 days. Positive dynamics of clinical data at the end of the course of inhalations (decrease of RR to 16 per minute, increase of Sa O2 to 90% on atmospheric air and to 95% on insufflation of humidified oxygen 5 l/min, improvement of auscultatory picture), as well as the control thoracic CT scan, which showed a decrease of lung parenchyma damage to 45.2% (CT-2), indicated the effectiveness and safety of this method in the complex rehabilitation of COVID-19 patient, being a basis for further investigation of this issue

Exogenous surfactant in the late respiratory phase of COVID-19

The article presents data on the course of inhalations with a native surfactant administered in two patients (66 and 53 years old) at the late respiratory phase of the new coronavirus infection of COVID-19 (the 22nd and the 19th days from the disease onset) who received non-invasive artificial lung ventilation.Subjects and methods.For inhalations, an AeroNeb™ micropump nebulizer was used; for one inhalation, 75 mg of surfactant-BL was dissolved in 5 ml of isotonic sodium chloride solution. The treatment course included 5 days with 2 inhalations a day.Results.In both patients, upon the end of this therapy with the native surfactant, regression of respiratory failure was noted, the level of respiratory support was reduced to insufflation with humidified oxygen, and rehabilitation measures were started with subsequent discharge from the hospital.

Application of the heated oxygen-helium mixture in rehabilitation of military servicers with arterial hypertension at the ambulatory-polycinic stage

Background. The professional activity of military personnel is characterized by complexity, high requirements for the state of physical and mental health, therefore, maintaining health and professional longevity is a priority task for the law enforcement agencies of the Russian Federation.&#x0D; Aims. The purpose of the study was to evaluate the effectiveness of the use of heated oxygen-helium mixture (OHM) in the rehabilitation of military personnel with arterial hypertension at the outpatient stage.&#x0D; Methods. The study included 68 people aged 32 to 56 (43,7 4,1) years. The patients were divided into two groups: Group I (n = 33) practically healthy volunteers, Group II (n = 35) patients with a verified diagnosis: arterial hypertension of I and II degrees, low and medium risk, the duration of the disease ranged from 1,5 to 18 (6.3 1.3) years. All patients included in the study underwent a course of inhalation of a heated OHM (the temperature of the mixture in the mask was 50С). Breathing was carried out in a cyclic-fractionated mode: breathing with a mixture 5 minutes, then breathing with atmospheric air 5 minutes (one cycle), 3 cycles per procedure. The course of treatment consisted of 1 procedure per day for 10 days from the first day of the study. The clinical efficacy of restorative treatment was assessed in three stages before the start of therapy, after the 5th and 10th procedures according to the following indicators: assessment of vegetative status using indicators of heart rate variability; express diagnostics of the psychoemotional state using the SAN questionnaire (well-being, activity, mood); assessment of adaptation of the cardiovascular system to physical activity using Martine's test with 20 squats.&#x0D; Results. In the second group, positive dynamics was noted in the form of normalization of the autonomic status, an increase in the activity of the parasympathetic division of the autonomic nervous system (an increase in SDNN, RMSSD indicators to 55 [4868] and 40 [3851 msec, respectively), a decrease in the tone of the sympathetic nervous system (normalization of the coefficient vagosympathetic balance LF/HF up to 1.1 [0.741.5]). The indicators of the SAN questionnaire have increased, which indicates an improvement in the psychoemotional state of servicemen. Patients with arterial hypertension, had positive dynamics in the rate of adaptive processes of restoration of the cardiovascular system after exercise (recovery time is 3.0 0.5 after the course).&#x0D; Conclusions. The use of a course of inhalations of a heated oxygen-helium mixture in the rehabilitation of servicemen with arterial hypertension has demonstrated its effectiveness in normalizing the psychoemotional state and vegetative status. In order to prevent the progression of arterial hypertension, this method can be included in rehabilitation programs at the outpatient and polyclinic stage.

ИЗМЕНЕНИЕ СОСТОЯНИЯ ГЕМОДИНАМИКИ НА ФОНЕ КУРСА СУРФАКТАНТ-ТЕРАПИИ У ПАЦИЕНТОВ С ГОРМОНАЛЬНО-ЗАВИСИМОЙ БРОНХИАЛЬНОЙ АСТМОЙ*

Non-specific hyperresponsiveness of the respiratory tract mucosa makes one of the important pathophysiological mechanisms for asthma development; it is characterized by the increased active response of the efferent system to stimuli. When this occurs, it damages the alveoli surfactant which ensures the viability of local immunity of lung tissue. Chronic respiratory failure induces changes in the cardiovascular system. The course of inhalations with a native surfactant reduces the dependence on inhalation corticosteroid. The objective of the study : to assess the effect of the course of inhalations with surfactant on the cardiovascular system in patients with hormone-dependent asthma. Materials and methods : 15 patients with asthma underwent a 70-day course of inhalation with natural surfactant based on a certain regimen (25 mg per inhalation, 21 inhalations in total) in addition to the basic therapy (inhaled corticosteroids and bronchodilators). On the 1st and 70th days of the surfactant therapy course, oscillometry was performed in order to assess macrohemodynamic parameters. Results. After the course of treatment, pulse pressure was found to increase by 26% compared to the initial level (p <0.05), the cardiac index increased by 16% (p <0.05) and the linear blood flow rate went up by 20% (p <0.05). At the same time, the pulse wave velocity decreased by 15% (p <0.05), while specific vascular resistance went down by 24% (p <0.01). This suggests that clinical remission during surfactant therapy in asthma patients is accompanied by changes in the functional state of the cardiovascular system.

A comparative evaluation of the effects on the crystallogenic properties of the rat blood serum for prolonged inhalations of nitric oxide or reactive oxygen species

The objective of this work was to study how a prolonged course of inhalations of nitric oxide or singlet oxygen modify crystallization of the blood serum in rats. Experiments were performed with 50 adult Wistar rats, which were divided into five equal groups. The control group (n = 10) included intact rats, which were not exposed to any manipulation other than a single blood drawing. Rats of groups 2, 3, and 4 received inhalations of nitric oxide at 20, 50, and 100 ppm, respectively, daily for 30 days. Group 5 rats (n = 10) received a similar course of inhalations of singlet oxygen for 30 days. Blood samples were drawn from the sublingual vein in rats of the test groups immediately after completion of the inhalation course (day 30 of the experiment) and in the recovery period (day 60 of the experiment) and tested for crystallogenic activity. Dried samples were evaluated visually for crystallizability, structure index, facia destruction degree, and marginal zone clarity, using respective scales. A prolonged course of NO inhalations was found to modulate the crystallogenic properties of the rat serum. An optimal response was recorded at the lowest nitric oxide concentration (20 ppm). Higher NO concentrations caused more adverse changes in serum crystallization after the end of the inhalation course and hindered the recovery processes. Singlet oxygen inhalations for 30 days did not exert a considerable adverse effect on the crystallogenic properties of the rat serum.

Experimental investigation of some systemic effects of nitric oxide inhalation

The goal of this work was to study the influence of nitric oxide inhalation on parameters of blood proand antioxidant systems in rats under both an intact condition and experimental thermal injury. We studied 40 Wistar rats that were divided into four equal groups. The intact group was subjected to no manipulation exnept a single blood sampling, main group I was subjected to inhalation of a air mixture containing 20 ppm of nitric oxide for 10 days, the control group was subjected to thermal injury and conventional treatment, and main group II was subjected to thermal injury and daily inhalation of nitric oxide (20 ppm) for 10 days. We studied the intensity of lipid peroxidation in the blood plasma, the total antioxidant activity, the peroxide resistance of erythrocytes, the level of malondialdehyde in the blood plasma and erythrocytes, and the activity of superoxide dismutase. It was shown that daily inhalations of a mixture containing a low concentration of nitric oxide (20 ppm) modified blood oxidative metabolism in healthy and burned rats. We hypothesized that the activation of lipid peroxidation in erythrocytes accompanied by a pronounced increase in the catalytic activity of superoxide dismutase is a unified response of healthy and burned rats to exogenous nitric oxide exposure. We also observed a moderate prooxidant effect in the blood plasma of healthy animals comparable to that in the erythrocytes of these rats. In the case of thermal injury, oxidative stress tended to be corrected after the end of the course of inhalation.

Correction of the functional state of aircraft-carrier aviation pilots by a course of inhalation of therapeutic doses of xenon during a long sea campaign

The article considers the efficacy of the courses of xenon-oxygen inhalation for the correction of the functional state of aircraft-carrier aviation pilots in a distant sea campaign. The course of inhalation procedures was shown to stabilize the vagosympathetic balance of the body, to restore the level of the functional state of the cardiovascular system, and to retain its functional reserve at an adequate level, thus considerably improving the subjective psychoemotional state of the pilots, which manifests itself in the improvement of self-esteem, an increase in activity, well-being, and mood, as well as in an adequate decrease in the level of reactive anxiety. The results obtained give evidence of the benefits of the use of special xenon-based gas mixtures for correcting the pilots’ functional state in the most stressful periods of their professional activity. Recommendations on the application of this method by military medicine have been given.

Influence of Singlet Oxygen Inhalation on the State of Blood Pro- and Antioxidant Systems and Energy Metabolism

Activity of lactate dehydrogenase in direct and reverse reactions, activity of aldehyde dehydrogenase, blood lactate and glucose levels, pro- and antioxidant balance in the blood were analyzed in rats after inhalations of singlet oxygen for 10 days. The course of inhalations improves antioxidant reserve of the blood and activity of blood oxidoreductases in healthy animals, thus strengthening the adaptive potential of the body.