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

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.