Clinical and laboratory aspects of vibroacoustic therapy in the complicated course of acute exogenous poisoning in the rehabilitation period

Background . An abrupt increase in the length of the rehabilitation period for acute poisoning (AP) is usually associated with concurrent pneumonia. In AP with psychopharmacological agents (pPPAs) we found a decreased tendency of platelets to spontaneous activation and hyperactivation, the pathology course being more favorable course against the background of vibroacoustic therapy (VAT). However, there are no detailed clinical and laboratory studies of VAT in various APs. The objective was to improve the efficacy of patient treatment for acute respiratory viral infection in a toxicological hospital by including VAT in the complex of therapeutic measures. Material and methods . Thirty two patients with pPPAs, with neurotoxicants (pNTs) and corrosive substances (pCSs) complicated by pneumonia were studied. The main group consisted of 19 patients in whom VAT was used (2–9 daily sessions of 5 minutes each); and 13 who received only the basic therapy made the comparison group. Hemorheology parameters, morphofunctional status of erythrocytes and platelets, as well as endotoxicosis were assessed in the blood of all patients before VAT initiation and 1–2 days after VAT completion. Results . In the main group, VAT made a moderate positive effect on hemorheology: a decrease in the initially increased (relative to normal) aggregation of red blood cells in motion (by 1.2 times) and an increase in the initially reduced (relative to normal) blood viscosity at shear rates of 2.5 s-1 and 62.8 s-1 (by 1.15 and 1.1 times, respectively); the impedance aggregometry revealed a statistically significant (p<0.05) 1.5-fold increase in platelet aggregation; their count increased (1.1-fold). At the same time, a statistically significant decrease (by 1.3 times) in the count of platelets with damaged membranes (p=0.03) and the elimination of the platelet tendency to spontaneous activation (p=0.04) were revealed. Among the standard indicators of endotoxicosis, there was a decrease in the leukocyte intoxication index (1.3 times) and blood leukocyte count (1.2 times). The VAT effect on the endotoxicosis severity was the greatest when assessed in terms of toxemia cellular component parameters: a statistically significant (p<0.05) decrease in the relative number of dead leukocytes (1.4 times) with the stabilization of their absolute count and an increase in the blood content of CD14+HLA-Dr+-monocytes (1.3 times). The VAT use significantly improved the AP course: in general, the length of pneumonia period decreased statistically significantly (p<0.05) (by 1.7 times) and the treatment duration was shortened (by 1.6 times); the length pneumonia period also decreased for PPPAs (by 1.2 times), and statistically significantly (p<0.05) decreased for PNTs (by 1.9 times); the treatment duration was reduced by 1.3 and 1.4 times, respectively. Conclusion . An evidently increased efficacy of rehabilitation treatment with VAT has been demonstrated. Further enhancement of VAT capabilities is expected through optimizing the VAT regimen and combining it with other treatment methods. It is important to study the morphofunctional properties of platelets along with the determination of their aggregation activity.