Actual issues of the practical use of parenteral ozone therapy in emergency medicine
Background. In recent years, ozone is increasingly used in medicine as a therapeutic agent, as evidenced by numerous scientific works in Ukraine and abroad. The positive effect of ozone on the oxygen transport function and rheological properties of the blood, activation of humoral immunity and increased analgesia explains the widespread use of ozone therapy in clinical medicine. Purpose of the study: to evaluate the clinical efficacy of parenteral ozone therapy as a component of intensive care for a number of emergency conditions and chronic diseases. Material and methods. The material for the study was the results of treatment of patients in the intensive care and extracorporeal treatment unit of the Kyiv City Clinical Emergency Hospital, who underwent a course of parenteral ozone therapy in 2018. Clinical indicators and treatment outcomes were evaluated retrospectively based on the analysis of cases histories. Research methods that were used: bibliosemantic, system analysis, comparative analysis, statistical method. Results. During the study period, 144 patients aged 17-72 years were treated: 84 women (58.3 %) and 60 men (41.7 %). All patients upon admission to the unit underwent a comprehensive clinical and laboratory examination. The clinical diagnosis and treatment plan were formed in accordance with the unified clinical protocols of the Ministry of Health of Ukraine. In accordance with the diagnoses, patients were divided into 5 clinical groups, for each of which key indicators of ozone therapy effectiveness were selected. The authors used a syndrome approach to assess the effectiveness of ozone therapy. The assessment was carried out in each group separately. Parenteral blood ozonation was carried out using the apparatus Boson-N plus in accordance with the methodology approved by the Ministry of Health of Ukraine (“Methods of ozone therapy”, 2001). A total of 304 medical procedures were carried out using ozone, among them: intravenous administration of ozonized saline solution - 36 people (169 procedures), blood ozonation - 25 people (185 procedures). On average, the total course of ozone treatment ranged from 3 to 10 procedures. The course of parenteral ozone therapy consisted of various procedures: intravenous administration of ozonized saline solution in a volume of 200 ml (dose of ozone - 0.48 mg) daily or every other day. During the procedure of blood ozonation, the patient’s blood was ozonized in a volume of 200 or 400 ml (the ozone dose was 1.8 mg or 1.8 mg + 1.8 mg, respectively). In patients with acute poisoning, ozone therapy was used to treat methaemoglobin formers and other hypoxic poisons (toxic effects of substances, mainly nonmedical ones (T51-T65), toxic effects of carbon monoxide (T58), toxic effects of other gases, fumes and fumes (T59), toxic effects of other and unidentified substances (T65)). In patients with acute infectious diseases, ozone therapy was used in the treatment of: herpes (B00), Lyme disease (A69.2), flu and pneumonia (J09-J18). In chronic diseases: psoriasis (L40), diabetes mellitus (E10-U14), complicated peripheral vascular disease (I79.2*), hypertension (I10) and hypertensive encephalopathy (167.4). In acute surgical pathology, ozone therapy was used in the following groups of diseases: thermal and chemical burns (T20-T32), furunculosis (L02.9), trophic ulcers of the lower extremities of various origins (L98.4) and other individual diseases. Complications during the treatment were not registered. Clinical criteria are the key in assessing the effectiveness of ozone therapy, therefore, the evaluation of pathological symptoms, syndromes and their dynamics is the basis for choosing the type and duration of a course of ozone therapy. Trainings of medical personnel in ozone therapy and safety techniques are an important component of effective treatment. Conclusions. Our experience with ozone therapy suggests that the method has significant prospects for the use in the treatment of a wide range of acute and chronic diseases and emergency conditions. Despite the fact that ozone therapy leads to significant positive changes in the human body, the method requires further study in order to improve and standardize.