Rehabilitation program for acute poisoning in a toxicological hospital

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Abstract

BACKGROUND: Diagnostics and treatment of acute poisoning, as well as the rehabilitation measures carried out in relation to them, including the stationary stage, are aimed at the most complete restoration of the lost capabilities of the body.

AIMS: Increasing the efficiency of medical rehabilitation of acute poisoning (AP) in a toxicological hospital through a combination of drug therapy and non-drug treatment with preformed physical factors.

MATERIAL AND METHODS: Of 1,207 patients with AP psychopharmacological agents (pPFA), neurotoxicants (pNT), cauterizing agents (pCA) and snake bites (SB), who were in the toxicology department of the N.V. Sklifosovsky, 421 patients with an unfavorable course of AP were subjected to an in-depth examination. Intravenous laser hemotherapy (LGT), hyperbaric oxygenation (HBO), mesodiencephalic modulation (MDM), wave biomechanotherapy (WBMT) and ethylmethylhydroxypyridine succinate (EP) were used in cases of 291 patients of the main groups.

RESULTS: The unfavorable course of AP was accompanied by an increase in the duration of treatment by 2.2–6.8 times due to the addition of pneumonia (pPFA), toxicohypoxic encephalopathy (pNT), severe burns of the gastrointestinal tract (pCA) and local edematous-inflammatory changes (SB). There was a syndrome of high blood viscosity and moderate endotoxicosis. The best clinical and laboratory results were obtained with a combination of LHT (90 minutes) with EP (pPFA), HBO and EP (pCA), HBO, MDM, EP (heavy pNT), HBO, EP (moderate pNT) and WBMT (SB). The adaptive capabilities of the organism, the state of the autonomic nervous system (pNT), neuropsychological indicators and electrical activity of the brain (pNT) improved.

CONCLUSION: Programmed rehabilitation made it possible to achieve a noticeable reduction in the incidence of symptoms of the studied poisoning (by 54.6–93.4%), the time to resolve their manifestations (by 9.1–75%), as well as inpatient treatment (by 16.1–59.3%), improving functional performance.

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About the authors

Yuri S. Goldfarb

N.V. Sklifosovsky Research Institute for Emergency Medicine; Russian Medical Academy of Continuous Professional Education

Author for correspondence.
Email: goldfarb@mail.ru
ORCID iD: 0000-0002-0485-2353
SPIN-code: 4638-3306

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow; Moscow

Amayak V. Badalyan

N.V. Sklifosovsky Research Institute for Emergency Medicine; Russian Medical Academy of Continuous Professional Education

Email: goldfarb@mail.ru
ORCID iD: 0000-0003-4429-2503
SPIN-code: 5094-7924

MD, Dr. Sci. (Med.), Assistant Professor

Russian Federation, Moscow; Moscow

Marina Yu. Marina

Russian Medical Academy of Continuous Professional Education

Email: goldfarb@mail.ru
ORCID iD: 0000-0002-1741-7246
SPIN-code: 7625-6452

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

Vladislav A. Shchetkin

N.V. Sklifosovsky Research Institute for Emergency Medicine

Email: goldfarb@mail.ru
ORCID iD: 0000-0002-5089-1097
SPIN-code: 8385-3751

MD, Dr. Sci. (Med.)

Russian Federation, Moscow

Mikhail M. Potskhveriya

N.V. Sklifosovsky Research Institute for Emergency Medicine; Russian Medical Academy of Continuous Professional Education

Email: goldfarb@mail.ru
ORCID iD: 0000-0003-0117-8663
SPIN-code: 6418-5480

MD, Cand. Sci. (Med.)

Russian Federation, Moscow; Moscow

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