Email this article Features of determining the severity of the condition of victims exposed to the chemical factor of fire
- Authors: Tolkach P.G.1, Kuznetsov O.A.2, Anokhin D.Y.1, Lodyagin A.N.2, Gayduk S.V.1, Basharin V.A1
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Affiliations:
- Kirov Military Medical Academy
- Janelidze Saint Petersburg Institute of Emergency Care
- Issue: Vol 25, No 1 (2025)
- Pages: 24-30
- Section: Clinical research
- URL: https://journals.rcsi.science/MAJ/article/view/312075
- DOI: https://doi.org/10.17816/MAJ546142
- EDN: https://elibrary.ru/QZYTFY
- ID: 312075
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Abstract
BACKGROUND: To determine the severity of the condition of the victims exposed to the chemical factor of the fire, they are guided by the content of carboxyhemoglobin in the blood. Inhalation exposure of combustion products of polymeric materials with pulmonotoxic effect leads to disruption of the structure and function of the respiratory system, which plays an important role in aggravating the condition of the victims and predicting the outcome.
AIM: To identify the features of determining the severity of the condition of victims exposed to the chemical factor of fire, depending on the calculated initial concentration of carboxyhemoglobin in the blood and the presence of interstitial changes in lung tissues.
METHODS: When conducting a retrospective analysis of the medical histories of victims exposed to the chemical factor of fire, the initial concentration of carboxyhemoglobin in the blood was calculated, X-rays of the chest cavity organs performed on the first day after admission were analyzed.
RESULTS: Depending on the calculated initial concentration of carboxyhemoglobin in the blood, patients with severe (59 [55; 60]%), moderate (42 [36; 43]%) and mild (18 [15; 24]%) severity. The duration of hospitalization of patients did not depend on a certain degree of severity. It was found that the duration of hospitalization (5 [4; 8] days) of patients with interstitial changes in the lungs detected on radiographs (47 ± 7% of victims) was higher (p = 0.03) compared (3 [2; 5] days) with patients in whom interstitial changes were not detected (53 ± 7% of victims). A moderate correlation (r = 0.31, p < 0.05) was determined between the duration of hospitalization of patients and the presence of interstitial changes on the part of the respiratory system.
CONCLUSION: The presence of interstitial changes in lung tissues identified during radiography should be considered as an unfavorable prognostic sign and taken into account when organizing medical care for victims exposed to the chemical factor of fire.
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##article.viewOnOriginalSite##About the authors
Pavel G. Tolkach
Kirov Military Medical Academy
Author for correspondence.
Email: pusher6@yandex.ru
ORCID iD: 0000-0001-5013-2923
MD, Dr. Sci. (Medicine), Deputy Head of the Department of Military Toxicology and Medical Protection
Russian Federation, Saint PetersburgOleg A. Kuznetsov
Janelidze Saint Petersburg Institute of Emergency Care
Email: kuznetcov_dr@inbox.ru
ORCID iD: 0000-0002-1275-9570
SPIN-code: 4656-5700
MD, Cand. Sci. (Medicine), Head of the Department of Toxicological Intensive Care
Russian Federation, Saint PetersburgDmitry Yu. Anokhin
Kirov Military Medical Academy
Email: damixon@mail.ru
ORCID iD: 0000-0003-4499-066X
SPIN-code: 6186-5543
MD, Cand. Sci. (Medicine), Lecturer at the Department of Radiology and Radiology with a Course of Ultrasound Diagnostics
Russian Federation, Saint PetersburgAlexey N. Lodyagin
Janelidze Saint Petersburg Institute of Emergency Care
Email: alodyagin@mail.ru
ORCID iD: 0000-0002-8672-2906
SPIN-code: 4886-8890
MD, Dr. Sci. (Medicine), Associate Professor, Head of the Center for Toxicology
Russian Federation, Saint PetersburgSergey V. Gayduk
Kirov Military Medical Academy
Email: gaiduksergey@mail.ru
ORCID iD: 0000-0003-1524-9493
SPIN-code: 8602-4922
MD, Dr. Sci. (Medicine), Assistant Professor, Deputy Head of the Department of Military Field Therapy
Russian Federation, Saint PetersburgVadim A Basharin
Kirov Military Medical Academy
Email: basharin1@mail.ru
ORCID iD: 0000-0001-8548-6836
SPIN-code: 4671-8386
MD, Dr. Sci. (Medicine), Professor, Head of the Department of Military Toxicology and Medical Protection
Russian Federation, Saint PetersburgReferences
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