bloodjourГематология и трансфузиологияRussian journal of hematology and transfusiology0234-57302411-3042ООО Издательский дом «Практика»10.35754/0234-5730-2022-67-4-500-509bloodjour-406Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESДинамический контроль лабораторных показателей при коррекции железодефицитных состояний у нейрохирургических больныхDynamic laboratory control of iron deficiency correction in neurosurgical patientshttps://orcid.org/0000-0001-8535-8535ТеряеваН. Б.TeryaevaN. B.

Теряева Надежда Борисовна, кандидат медицинских наук, врач клинической лабораторной диагностики

125047, Москва

Nadezhda B. Teryaeva, Cand. Sci. (Med.), Doctor of Laboratory Diagnostics

125047, Moscow

nteryaeva@nsi.ruhttps://orcid.org/0000-0002-6147-7887КванО. К.KvanO. K.

Кван Оксана Климентиевна, заведующая отделением клинической и производственной трансфузиологии

125047, Москва

Oksana K. Kvan, Head of the Department of Clinical and Productional Transfusion

125047, Moscow

okvan@nsi.ruhttps://orcid.org/0000-0002-9850-050XГаджиеваО. А.GadjievaO. A.

Гаджиева Ольга Александровна, кандидат медицинских наук, заведующая лабораторией клинико-диагностических исследований

125047, Москва

Olga A. Gadjieva, Cand. Sci. (Med.), Head of the Clinical Diagnostic Laboratory

125047, Moscow

ogadjieva@nsi.ruhttps://orcid.org/0000-0002-5559-2678БаширянБ. А.BashiryanB. A.

Баширян Борис Аванесович, врач клинической лабораторной диагностики

125047, Москва

Boris A. Bashiryan, Doctor of Laboratory Diagnostics

125047, Moscow

bbashiryan@nsi.ruФГАУ «Национальный медицинский исследовательский центр нейрохирургии имени академика Н.Н. Бурденко» Министерства здравоохранения Российской ФедерацииРоссияN.N. Burdenko National Medical Research Center of NeurosurgeryRussian Federation202227122022674500509Copyright © Теряева Н.Б., Кван О.К., Гаджиева О.А., Баширян Б.А., 20222022Теряева Н.Б., Кван О.К., Гаджиева О.А., Баширян Б.А.Teryaeva N.B., Kvan O.K., Gadjieva O.A., Bashiryan B.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.htjournal.ru/jour/article/view/406Введение

Введение. Концепция менеджмента крови применительно к оперативному лечению хирургических заболеваний рекомендует коррекцию железодефицитной анемии (ЖДА) на догоспитальном этапе. Однако часто оперативное вмешательство выполняется по экстренным показаниям, в связи с чем необходимо провести лечение в максимально короткие сроки.

Цель – оценить возможности использования показателя дельты гемоглобина (Delta-He) для мониторинга эффективности терапии ЖДА у нейрохирургических больных на догоспитальном этапе для сокращения сроков их подготовки к госпитализации.

Материалы и методы

Материалы и методы. Всего 42 больных получали терапию высокодозными препаратами железа (железа [III] карбоксимальтозат и железа [III] гидроксид олигоизомальтозат). При проведении лечения оценивали динамику количества ретикулоцитов и значений Delta-He. Данные представлены как медианы и межквартильные интервалы.

Результаты

Результаты. Лечение высокодозными препаратами железа приводило к повышению значений Delta-He начиная с 1–2-го дня, значимые изменения были зафиксированы к 3–4-му дню от начала терапии: с 2,2 (0,3–4,9) до 15,5 (13,8–10) пг к 7-м суткам. Эти изменения на 2–3 дня опережали увеличение количества ретикулоцитов в соответствующих образцах крови: количество ретикулоцитов значимо увеличивалось к 5–6-му дню от начала лечения.

Заключение

Заключение. Применение высокодозных препаратов железа [III] карбоксимальтозат и железа [III] гидроксид олигоизомальтозат в виде инфузии позволило в течение недели подготовить к госпитализации нейрохирургических больных. Ни одному из больных ни на одном из этапов хирургического лечения не потребовалась трансфузия эритроцитсодержащих компонентов донорской крови. Возможность при проведении терапии препаратами железа ориентироваться на значения Delta-He вместо количества ретикулоцитов позволило на 2–3 дня сократить период ожидания эффекта медикаментозного воздействия.

Introduction

Introduction. The concept of blood management in relation to the surgical treatment of surgical diseases recommends the correction of iron defi ciency anemia (IDA) at the prehospital stage. However, surgery is often performed for emergency indications, making it necessary to carry out treatment as soon as possible.

Aim – to evaluate the possibilities of using delta hemoglobin (Delta-He) to monitor the effectiveness of IDA therapy in neurosurgical patients at the prehospital stage to reduce the time required to prepare patients for hospitalization.

Materials and methods

Materials and methods. A total of 42 patients were treated with high-dose iron preparations (iron [III] carboxymaltosate and iron [III] hydroxide oligoisomaltosate). During the treatment, the dynamics of the number of reticulocytes and the values of the hemoglobin delta were evaluated. Data are presented as median (IQR).

Results

Results. Treatment with high-dose iron preparations led to an increase in Delta-He values starting from days 1–2. Significant changes were recorded by days 3–4 from the start of therapy: from 2.2 (0.3–4.9) pg to 15.5 (13.8–10) pg on day 7. These changes were 2–3 days ahead of the increase in the number of reticulocytes in the corresponding blood samples: the number of reticulocytes significantly increased by days 5–6 from the start of treatment.

Conclusion

Conclusion. The use of high-dose preparations of iron [III] carboxymaltosate and iron [III] hydroxide oligoisomaltosate in the form of infusion made it possible to prepare neurosurgical patients for hospitalization within a week. None of the patients required transfusion of erythrocyte-containing components of donated blood at any stage of surgical treatment. The ability to focus on Delta-He values instead of the number of reticulocytes during iron therapy made it possible to shorten the waiting period for the effect of drug exposure by 2–3 days.

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The authors declare that there are no conflicts of interest present.