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.

1. Goldfarb YuS, Badalyan AV, Gerasimenko MYu, Shchetkin VA, Potskhveriya MM, Elkov AN. Reabilitatsionnye meropriyatiya pri ostrykh otravleniyakh khimicheskoy etiologii v toksikologicheskom statsionare. Saratov: Nauka Publ.; 2023. (In Russ.).

2. Goldfarb YuS, Glukhovskaya NYa, Shirinova MN, Burykina IA, Potskhveriya MM. Ultrafioletovoe obluchenie krovi pri ostrykh ekzogennykh otravleniyakh v profilaktike i lechenii pnevmoniy. Klinicheskaya meditsina. 1987;(3):49–52. (In Russ.).

3. Gembitskiy EV, Gayduk VA. Ostraya dykhatel'naya nedostatochnost' pri otravlenii fosfororganicheskimi insektitsidami (klinika, patogenez, differentsirovannaya terapiya). Terapevticheskiy arkhiv. 1977;(1):75–80. (In Russ.).

4. Ilyashenko KK, Luzhnikov EA. Toksicheskoe porazhenie dykhatel'noy sistemy pri ostrykh otravleniyakh. Moscow: ID Medpraktika-M Publ.; 2004. (In Russ.).

5. Gorbakov VV. Kliniko-immunologicheskaya kharakteristika tyazhelykh otravleniy uksusnoy kislotoy i immunokorrektsiya lizotsimom: Cand. med. sci. diss. Synopsis. Moscow; 1991. Available at: http://www.dslib.net/anestezia/kliniko-immunologicheskaja-harakteristika-tjazhelyh-otravlenij-uksusnoj-kislotoj-i.html [Accessed April 7, 2025]. (In Russ.).

6. Luzhnikov EA, Goldfarb YuS. Fiziogemoterapiya ostrykh otravleniy. Moscow: Medpraktika-M Publ.; 2002. (In Russ.).

7. Eremenko AA, Zyulyaeva TP, Kalinina AA, Rozina NA. Evaluation of effectiveness of vibroacoustic lung massage in self-breathing patients after cardiosurgical operations. Clinical and Experimental Surgery. Petrovsky Journal. 2020;8(4):126–134. (In Russ.). https://doi.org/10.33029/2308-1198-2020-8-4-126-134

8. Garus YN, Antoshkieva RM. The effectiveness of treatment of chronic generalized catarrhal gingivitis with mild antiseptic octenisept, vibroacoustic and antioxidant therapy. Astrakhan medical journal. 2011;6(4):119–121. (In Russ.).

9. Makarov MS, Goldfarb YuS, Badalyan AV, Simonova AYu, Potskhveriya MM. The effect of vibroacoustic therapy on the structural integrity of erythrocytes and platelets in patients with acute exogenous poisoning. Transplantologiya. The Russian Journal of Transplantation. 2024;16(3):303–312. (In Russ.). https://doi.org/10.23873/2074-0506-2024-16-3-303-312

10. Goldfarb YS, Badalyan AV Marina M.Y, Shchetkin VA, Potskhveriya MM. Rehabilitation program for acute poisoning in a toxicological hospital. Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2021;20(2):99–117. (In Russ.). https://doi.org/10.17816/1681-3456-2021-20-2-2

11. Alentiev AYu, Belov NA, Nikiforov RYu, Polunin EV, Borovkova NV, Evseev AK, et al. Gas permeation and hemocompatibility of novel perfluorinated polymers for oxygenation of blood. Membranes and Membrane Technologies. 2018;8(4):217– 223. (In Russ.). https://doi.org/10.1134/S2218117218040028

12. Khvatov VB, Makarov MS, Borovkova NV. The morphologic evaluation of adhesive activity of human thrombocytes using vital dye. Klinicheskaya Laboratornaya Diagnostika (Russian Clinical Laboratory Diagnostics). 2013;(7):58–61. (In Russ.).

13. Makarov MS. Morphofunctional properties of spindle-shaped platelets. Bulletin of Experimental Biology and Medicine. 2022;174(11):646–649. (In Russ.). https://doi.org/10.47056/0365-9615-2022-174-11-646-649

14. Gabrielyan NI, Dmitriyev AA, Kulakov GP, Melikyan AM, Shcherbaneva OI. Diagnosticheskaya tsennost opredeleniya srednikh molekul v plazme krovi pri nefrologicheskikh zabolevaniyakh. Klinicheskaya meditsina. 1981;59(10):38–42. (In Russ.).

15. Kalf-Kalif YaYa. O leykotsitarnom indekse intoksikatsii i yego prakticheskom znachenii. Vrachebnoye delo. 1941;(1):31–36. (In Russ.).

16. Kapitanenko A.M., Dochkin I.M. Klinicheskiy analiz laboratornykh issledovaniy v praktike voyennogo vracha. Moscow: Voyenizdat Publ.; 1985. (In Russ.).

17. Gavrilov VB, Gavrilova AR, Mazhul LM. Methods of determining lipid peroxidation products in the serum using a thiobarbituric acid test. Voprosy Meditsinskoi Khimii. 1987;33(1):118–122. (In Russ.).

18. Zelenin AV, Poletaev AI, Stepanova NG, Barsky VE, Kolesnikov VA, Nikitin SM, et al. 7-Amino-actinomycin D as a specific fluorophore for DNA content analysis by laser flow cytometry. Cytometry. 1984;5(4):348–354. PMID: 6468175 https://doi.org/10.1002/cyto.990050410

19. Morse EE, Yamase HT, Greenberg BR, Sporn J, Harshaw SA, Kiraly TR, et al. The role of cytometry in the diagnosis of lymphoma: a critical analysis. Ann Clin Lab Sci. 1994;24(1):6–11. PMID: 8147568

20. Borovkova NV, Aleksandrova IV, Valetova VV, Kobzeva EN. Blood lymphocyte apoptosis in norm and pathology. Molecular medicine (Molekulyarnaya Meditsina). 2013;(4):41–45. (In Russ.).

21. Mengos AE, Gastineau DA, Gustafson MP. The CD14+HLA-DRlo/neg monocyte: an immunosuppressive phenotype that restrains responses to cancer immunotherapy. Front Immunol. 2019;10:1147. PMID: 31191529 https://doi.org/10.3389/fimmu.2019.01147

22. Minkov G, Dimitrov E, Yovtchev Y, Enchev E, Lokova R, Halacheva K. Prognostic value of peripheral blood CD14+HLA-DR+ monocytes in patients with acute pancreatitis. J Immunoassay Immunochem. 2021;42(5):478–492. PMID: 33818295 https://doi.org/10.1080/15321819.2021.1903491

23. Kvasnikov AM, Borovkova NV, Petrikov SS, Godkov MA, Andreev YuV, Storozheva MV, et al. Regulation of lymphocyte apoptosis in intensive care patients with COVID-19. Russian Journal of Anesthesiology and Reanimatology. 2023;(1):49–55. (In Russ.). https://doi.org/10.17116/anaesthesiology202301149

24. Runion R. Spravochnik po neparametricheskoy statistike: sovremennyy podkhod. Moscow: Finansy i statistika Publ.; 1982. (In Russ.).

25. Smirnov NV, Dunin-Barkovskiy IV. Kurs teorii veroyatnostey i matematicheskoy statistiki dlya tekhnicheskikh prilozheniy. Moscow: Nauka Publ.; 1969. (In Russ.).

26. Кобзарь А.И. Прикладная математическая статистика для инженеров и научных работников. 2-е изд. Москва: Физматлит, 2012. Kobzar AI. Prikladnaya matematicheskaya statistika dlya inzhenerov i nauchnykh rabotnikov. 2nd ed. Moscow: Fizmatlit Publ., 2012. (In Russ.).

27. Le meshko BYu. Kriterii proverki otkloneniya raspredeleniya ot normalnogo zakona. Rukovodstvo k primeneniyu. Moscow: Infra-M Publ.; 2023. (In Russ.).

28. Lapshin VP, Goldfarb YuS, Chzhao AV, Krasilnikov AM, Seraya EV, Shipilov IV, et al. Transcranial electric stimulation in therapy of critical states range of application and perspectives of development. Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2007;(1):45–47. (In Russ.).

29. Badalyan AV, Bitkova EE, Goldfarb YuS, Khvatov VB, Elkov AN, Levina OA. Disturbances of rheological blood parameters and their correction in acute chemical poisonings at rehabilitation stage. Tromboz, Gemostaz i Reologiya. 2016;1(65):81–90. (In Russ.).

30. Potskhveriya MM, Matkevich VA, Goldfarb YuS, Simonova AYu, Stolbova NE, Tyurin IA, et al. The program of enteral correction of homeostasis disorders and its effect on intestinal permeability in acute poisoning. Transplantologiya. The Russian Journal of Transplantation. 2022;14(1):45-57. (In Russ.). https://doi.org/10.23873/2074-0506-2022-14-1-45-57

31. Kadikoylu G, Yavasoglu I, Bolaman Z, Senturk T. Platelet parameters in women with iron deficiency anemia. J Natl Med Assoc. 2006;98(3):398–402. PMID: 16573304

32. Talamo G, Oyeleye O, Paudel A, Tayyab H, Khan M, Meseeha MG, et al. Platelet levels before and after iron replacement therapy in patients with iron deficiency anemia. Hematology. 2025;30(1):2458358. https://doi.org/10.1080/16078454.2025.2458358

33. Kulnigg-Dabsch S, Evstatiev R, Dejaco C, Gasche C. Effect of iron therapy on platelet counts in patients with inflammatory bowel disease-associated anemia. PLoS One. 2012;7(4):e34520. PMID: 22506024 https://doi.org/10.1371/journal.pone.0034520

34. Olivier CB, Meyer M, Bauer H, Schnabel K, Weik P, Zhou Q, et al. The ratio of ADP- to TRAP-induced platelet aggregation quantifies P2Y12-dependent platelet inhibition independently of the platelet count. PLoS One. 2016;11(2):e0149053. PMID: 26885820 https://doi.org/10.1371/journal.pone.0149053

35. Wustrow I, Ebner C, Langwieser N, Haller B, Luppa PB, Bradaric C, et al. Influence of diagnosis of venous thromboembolism on immature platelets, absolute platelet count and platelet aggregation over time. Platelets. 2021;32(3):398–403. PMID: 32316806 https://doi.org/10.1080/09537104.2020.1754380

36. Ma L, Wu Q, Ma Q, Liang S, Mo Q, Huang C. Platelet aggregation in apparently healthy elderly populations: reference ranges and influence of hematology parameters. Clin Lab. 2023;69(2). PMID: 36787562 https://doi.org/10.7754/Clin.Lab.2022.220438

37. Scavone M, Podda GM, Tripodi A, Cattaneo M. Whole blood platelet aggregation measurement by Multiplate™: potential diagnostic inaccuracy of correcting the results for the sample platelet count. Platelets. 2023;34(1):2156493. PMID: 36550076 https://doi.org/10.1080/09537104.2022.2156493

38. Stolyar MA, Olkhovsky IA. On issue of detection of limits of normal reaction of thrombocytes in testing of impedance aggregometry. Russian Clinical Laboratory Diagnostics. 2016;61(6):359–363. (In Russ.). https://doi.org/10.18821/0869-2084-2016-61-6-359-363

39. Markhulia DC, Popugaev KA, Sychev DA, Vatsik-Gorodetskaya MV, Gazaryan GA, Godkov MA, et al. Laboratory evaluation of the platelet component of hemostasis in acute coronary syndrome with ST segment elevation. Russian Sklifosovsky Journal "Emergency Medical Care". 2025;14(1):47-60. (In Russ.). https://doi.org/10.23934/2223-9022-2025-14-1-47-60

40. Giordano S, Franchi F, Rollini F, Al Saleh T, Uzunoglu E, Costa F, et al. Effect of lipid-lowering therapy on platelet reactivity in patients treated with and without antiplatelet therapy. Minerva Cardiol Angiol. 2024;72(5):489– 505. PMID: 37870424 https://doi.org/10.23736/S2724-5683.23.06411-6

41. Makarov MS. Noncanonic ways to human platelet activation. Medical alphabet. 2015;3(11):30–35. (In Russ.).

42. Surovikina MS, Samoilenko VV, Vlasova EA, Vasilenko IA, Suslov VP. Changes in plasmic and platelet hemostasis in patients with chronic renal failure in hemodialysis. Urologiia. 2012;(1):25–29. (In Russ.).

43. Baaten CCFMJ, Nagy M, Bergmeier W, Spronk HMH, van der Meijden PEJ Platelet biology and function: plaque erosion vs. rupture. Eur Heart J. 2024;45(1):18–31. PMID: 37940193 https://doi.org/10.1093/eurheartj/ehad720

44. Kikuchi Y, Koyama T. Red blood cell deformability and protein adsorption on red blood cell surface. Am J Physiol. 1984;247(5 Pt 2):H739–47. PMID: 6496755 https://doi.org/10.1152/ajpheart.1984.247.5.H739

45. Luzhnikov EA, Goldfarb YuS, Musselius SG. Detoksikatsionnaya terapiya: rukovodstvo dlya vrachey. Saint Petersburg: Lan Publ.; 2000. (In Russ.).

46. Goldfarb YuS. Kompleksnaya detoksikatsiya pri lechenii ostrykh otravleniy. In: Meditsinskaya toksikologiya: natsionalnoye rukovodstvo. Moscow: GEOTAR-Media Publ.; 2012. Sect. 4.5. 294–304. (In Russ.).

47. Luzhnikov EA, Goldfarb YuS, Badalyan AV. Present-day detoxification therapy for acute poisonings of chemical etiology. Toxicological Review. 2014;3(26):9–17. (In Russ.).