STUDY OF THE EFFECT OF LITHIUM AND SILVER MODIFIED SORBENT ON HEMOSTATIC REACTIONS IN VITRO

Introduction. Hemosorption, as a method of sorption detoxification, is used successfully in a complex of intensive care measures for patients with a number of pathologies. The range of application of the method can be expanded by using modified sorbents with biologically active components, in particular silver and lithium. Objective. To evaluate the effect of lithium- and silver-containing sorbents based on aluminum oxide and polydimethylsiloxane on the quantitative content of platelets and on the features of the hemostatic response under conditions of dosed contact of the sorbent with donor blood. Materials and Methods. The study included an analysis of the effect on various clotting parameters of donated blood after contact with the sorbent Al2O3@PDMS/Li-Ag, obtained on the basis of aluminum oxide (Al2O3) and polydimethylsiloxane (PDMS) with the inclusion of modifiers of lithium (Li, 0.5%) and silver (Ag, 0.1%) compared to the sorbent without modifiers, and with sorbents containing them separately. Studies of the hemostasis system included determination of platelet count, chronometric parameters, fibrinogen concentration, antithrombin activity, and plasminogen content. Calibrated thrombography and computed thromboelastometry were used for the integral assessment. Statistical processing was performed using descriptive statistics, comparative analysis, and the nonparametric Kruskal-Wallis H test using the statistical software package MedCalcVersion17.9. Results. All sorbents moderately reduced platelet count (by 6.3-11.0% of the initial value) under contact conditions. Sorbents Al2O3@PDMS and Al2O3@PDMS/Ag contribute to the development of a hypercoagulation shift, as seen by the 1.4-fold shortening of the kaolin clotting time (KV). On the contrary, the inclusion of lithium in the sorbents (Al2O3@ PDMS /Li, Al2O3@PDMS/Li-Ag) was not accompanied by activation, but by suppression of blood clotting, as evidenced by a prolongation of the KV values by 1.3 and 1.5 times, as well as the indicators of activated partial thromboplastin time (APTT) by 1.5 and 1.6 times, respectively. This is also evidenced by pronounced hypocoagulation in terms of CB (silicone time). Conclusion. The introduction of biologically active components, lithium and silver, into the sorbent makes it possible to obtain an original hemosorbent with new properties. The results showed the absence of a hypercoagulation shift, which indicates the potential for the sorbent as a basis for the development of safe medicines and medical devices.