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Prevention of infectious complications in patients with severe combined injury using native deoxyribonucleic acid drug

https://doi.org/10.24884/2072-6716-2024-25-2-51-59

Abstract

The objective of the study: improve the course of traumatic disease and reduce the number of complications in victims with severe combined injury (SCI). Material and methods. Included were 60 patients with SCI who were consecutively admitted to a level I trauma center with shock of II or III severity and a positive prognosis for life. Design: double-blind, placebo-controlled, single-center study. For an additional 10 days in a row, starting from the 2nd day, all victims were injected once daily intramuscularly with 5 ml of a 0.015% solution of sodium deoxyribonucleate or placebo (saline solution). Results. The final distribution into groups: I main (27 people) — with the drug and II comparison (27 people) — with placebo. The groups did not differ in gender, age, severity of injury and shock, or treatment received. In 48% I group and 52% II group complications developed. Their sum (21) in I group was less than in II group (39), p=0.102. The reduction was achieved due to infectious non-life-threatening complications (gr. I — 1, gr. II — 12, p=0.001). Duration of anemia in days (blood hemoglobin <100 g/l) in I group was less (175 days) compared to group II. (316 days), p=0.010. Similarly, for hypoproteinemia (total protein <60 g/l): the sum of days in I group less (199 days) than in group II (343 days), p=0.036. In the subgroups with complications, after 7–14 days, the number of stem cells in the blood that stimulate healing increased only in patients of group I (CD117+ by 290%, p=0.000 and CD34+ by 200%, p=0.034). Also, only in them did the content of functionally mature neutrophilic granulocytes (NG) containing antimicrobial defensins (Def+NG) increase by 26%, p=0.019. Died in I group — 1 person, in II group — 2. Duration of hospitalization in group I — 32.8±4.1 days, in II group — 39.6±6.6 days. Conclusion. Administration of sodium deoxyribonucleate increases the number of stem cells and Def+NG in the blood, reduces the duration of anemia and hypoproteinemia, which leads to a reduction in the number of complications and treatment time for victims with SCI.

About the Authors

A. N. Tulupov
St. Petersburg Dzhanelidze Research Institute of Emergency Care
Russian Federation

Alexander N. Tulupov

St. Petersburg



M. I. Gromov
St. Petersburg Dzhanelidze Research Institute of Emergency Care
Russian Federation

Mikhail I. Gromov 

St. Petersburg



L. P. Pivovarova
St. Petersburg Dzhanelidze Research Institute of Emergency Care
Russian Federation

Ludmila P. Pivovarova 

St. Petersburg



A. V. Nikitin
St. Petersburg Dzhanelidze Research Institute of Emergency Care
Russian Federation

Alexander V. Nikitin 

St. Petersburg



V. N. Lapshin
St. Petersburg Dzhanelidze Research Institute of Emergency Care
Russian Federation

Vladimir N. Lapshin 

St. Petersburg



O. B. Ariskina
St. Petersburg Dzhanelidze Research Institute of Emergency Care
Russian Federation

Olga B. Ariskina 

St. Petersburg



I. V. Osipova
St. Petersburg Dzhanelidze Research Institute of Emergency Care
Russian Federation

Irina V. Osipova 

St. Petersburg



A. V. Fedorov
St. Petersburg Dzhanelidze Research Institute of Emergency Care
Russian Federation

Alexei V. Fedorov 

St. Petersburg



References

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2. Kaplina E.N., Vaynberg Yu.P. Derinat — a natural immunomodulator for children and adults. 3rd ed. rev. and enl. Moscow: Publishing house Nauchnaya kniga, 2007, 240 p. (In Russ.).

3. Pivovarova L.P., Gromov M. I., Tulupov A. N. et al. Correction of bone marrow failure in patients with polytrauma by injection of native DNA fragments (randomized prospective double-blind placebo-controlled study // Scirea Journal of Clinical Medicine. 2021. Vol. 6, No 3. Р. 242–259. doi: 10.54647/cm32508.

4. Tsibin Yu.N., Galtseva I. V., Rybakov I. R. Prediction of outcomes of severe trauma complicated by shock. Traumatic shock. Leningrad: Publishing house Meditsina, 1976, pp. 59–62 (In Russ.).


Review

For citations:


Tulupov A.N., Gromov M.I., Pivovarova L.P., Nikitin A.V., Lapshin V.N., Ariskina O.B., Osipova I.V., Fedorov A.V. Prevention of infectious complications in patients with severe combined injury using native deoxyribonucleic acid drug. EMERGENCY MEDICAL CARE. 2024;25(2):51-59. (In Russ.) https://doi.org/10.24884/2072-6716-2024-25-2-51-59

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