transmedТрансляционная медицинаTranslational Medicine2311-44952410-5155Almazov National Medical Research Centre, Saint Petersburg, Russia10.18705/2311-4495-2023-10-2-96-104transmed-491Research ArticleСЕРДЕЧНО-СОСУДИСТЫЕ ЗАБОЛЕВАНИЯCARDIOVASCULAR MEDICINEПрименение технологии супернасыщения крови кислородом (SSO2 терапии) у пациентов с острой ишемией миокардаUsing of supersaturated oxygen delivery (SSO2 therapy) in patients with acute myocardial ischemiahttps://orcid.org/0000-0001-8178-0704РадовскийА. М.RadovskiyA. M.

Радовский Алексей Максимович, к.м.н., врач анестезиолог-реаниматолог

ул. Аккуратова, д. 2, Санкт-Петербург, 197341

Aleksey M. Radovskiy, PhD, anesthesiologistresuscitator

Saint Petersburg

radovskiy_am@almazovcentre.ruБаутинА. Е.BautinA. E.

Баутин Андрей Евгеньевич, д.м.н., доцент, заведующий НИЛ анестезиологии и реаниматологии

Санкт-Петербург

Andrey E. Bautin, M.D., associate professor, head of the Research Laboratory of Anesthesiology and Intensive Care

Saint Petersburg

ЯковлевА. Н.YakovlevA. N.

Яковлев Алексей Николаевич, к.м.н., заведующий НИЛ острого коронарного синдрома

Санкт-Петербург

Aleksey N. Yakovlev, PhD, head of Acute Coronary Syndrome Laboratory

Saint Petersburg

ШляхтоЕ. В.ShlyakhtoE. V.

Шляхто Евгений Владимирович, д.м.н., профессор, академик РАН, генеральный директор

Санкт-Петербург

Evgeny V. Shlyakhto, M.D., professor, academician of the Russian Academy of Sciences, General Director

Saint Petersburg

Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской ФедерацииРоссияAlmazov National Medical Research CentreRussian Federation20232005202310296104Copyright © Радовский А.М., Баутин А.Е., Яковлев А.Н., Шляхто Е.В., 20232023Радовский А.М., Баутин А.Е., Яковлев А.Н., Шляхто Е.В.Radovskiy A.M., Bautin A.E., Yakovlev A.N., Shlyakhto E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://transmed.almazovcentre.ru/jour/article/view/491

Кислород является основным участником окислительно-восстановительных реакций в организме. Дефицит кислорода даже на короткий промежуток времени может привести к дисфункции органа. Так, снижение кровотока в определенном регионе миокарда у пациентов с ишемической болезнью сердца может стать причиной инфаркта. Экспериментальные исследования подтвердили, что ранняя реперфузия уменьшает размер инфаркта, а клинические исследования показали, что ранняя эффективная реперфузия пораженной артерии и предотвращение повторной окклюзии являются основой для минимизации размера инфаркта и смертности.

Своевременно выполненное чрескожное вмешательство у пациентов с острым инфарктом миокарда значительно снизило показатель смертности и риск развития сердечной недостаточности. Однако, несмотря на эффективность эндоваскулярного лечения, сохраняется потребность в дополнительных методах кардиопротекции, направленных на уменьшение зоны инфаркта миокарда и профилактику развития сердечной недостаточности и неблагоприятного ремоделирования левого желудочка. Одним из адъювантных способов кардиопротекции при лечении пациентов с острой ишемией миокарда является метод супернасыщения крови кислородом (SSO2 терапия).

В данном обзоре представлена информация о возможных механизмах реализации кардиопротективных эффектов SSO2 терапии, описана технология и оснащение, необходимое для применения данной методики. Кроме того, освещены результаты экспериментальных и клинических исследований, посвященных SSO2 терапии. Следует отметить, что до настоящего времени было выполнено лишь одно многоцентровое проспективное рандомизированное контролируемое исследование с равномерной рандомизацией. Таким образом, использование данной технологии ограничено необходимостью применения коммерческой установки.

Oxygen is the main participant in redox reactions in the body and its deficiency can lead to organ dysfunction. Thus, a decrease in blood flow in a certain region of the myocardium in patients with coronary heart disease can cause a heart attack. According to experimental studies, early reperfusion reduces infarct size, and clinical studies have shown that early effective reperfusion of the affected artery and prevention of re-occlusion is the basis for minimizing infarct size and mortality.

Timely performed percutaneous intervention in patients with acute myocardial infarction significantly reduced the mortality rate and the risk of heart failure. Despite the endovascular treatment effectiveness, there is still a need for additional methods of cardioprotection, reducing the area of myocardial infarction and preventing the development of heart failure and adverse left ventricular remodeling. Blood oxygen supersaturation (SSO2 therapy) is one of the adjuvant methods of cardioprotection in the treatment of patients with acute myocardial ischemia.

This review describes possible mechanisms for implementing the cardioprotective effects of SSO2 therapy, technology and equipment necessary for the application of this technique. In addition, the results of experimental and clinical studies on SSO2 therapy are consecrated. Of note, only one multicentre prospective randomized controlled trial with uniform randomization was performed. Thus, the use of this technology is limited by the use a commercial equipment.

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