Адаптационная динамика реологических свойств крови у медицинских работников, оказывающих экстренную помощь:

Abstract

Aim: to investigate the adaptation mechanisms of changes in hemodynamic and autonomic indexes of the medical workers provide urgent medical assistance in response to stress factors. \nMaterials and methods. We examined 35 ambulance station workers before and after daily duty. The characteristics of the microcirculatory blood flow were assessed by the method of dynamic light scattering from red blood cells using Elfi-Tech (Rehovot, Israel) mDLS sensor (miniaturized Dynamic Light Scattering). The signal is integrated in the form of 3 hemodynamic indices (HI – Hemodynamic Index). The low-frequency index (HI1) is determined by the slow interlayer interaction, the high-frequency region (HI3) characterizes the fast processes of layer shift. HI2 occupies an intermediate position (precapillary and capillary blood flow). Fluctuations RR intervals were estimated by the method of heart rate variability (HRV). To increase the sensitivity, additional stress load was introduced, that was created using the Stroop test. \nResults. At rest after duty, a significant decrease is noted in the HI1 component. Under the influence of the Stroop-test, the dynamics of changes expands and captures the normalized RHI2 index that decreases, and also the RHI3 indicator that significantly increases. After duty, significantly lower heart rate (HR) was detected. At the same time, increased rates of overall heart rate variability (SDNN, RMSSD) were observed. The frequency components (LF, HF) increased significantly, but their ratio did not change. The nonlinear parasympathetic index (CVI) increased. \nConclusion. Emergency 24 hour load on the doctor leads to significant changes in hemodynamic processes, but they are detected only when additional short-term load is applied, that demonstrates a decrease of adaptive reserves. 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