Novosti
Khirurgii

 This journal is
indexed in Scopus
journal cover
android icon Android Applicaion

Year 2013 Vol. 21 No 5

GENERAL AND SPECIAL SURGERY

Y.P. ORLOV1, V.N. LUKACH1, A.V. GLUSCHENKO1,2

REAMBERIN IN THE INTENSIVE THERAPY PROGRAM IN PATIENTS WITH GENERALIZED PERITONITIS

SBEE HPE "Omsk State Medical Academy"1,
Omsk Municipal Clinical Emergency Hospital2,
The Russian Federation

Objectives. To determine reamberin efficiency in the intensive therapy program of generalized peritonitis (GP) for correction of the rheological disorders, providing of effective oxygen supply to tissues, restoration of oxidative phosphorylation and tissue reparation.
Methods. 24 patients with GP were included in the study (severe abdominal sepsis) due to destructive appendicitis, perforated gastric and duodenal ulcers. 2 groups were formed in the postoperative period. The main group (n=12) consisted of 6 men (aged of 31,4±3,3 years (M±σ)) and 6 women (aged 32,4±2,4 years (M±σ)) with GP (according to Mannheim scale 30,4±2,1 scores (M±σ)) where reamberin was used in the program of the infusion therapy. The comparison group (n=12) consisted of 4 men (34,3±3,1 years scores (M±σ)) and 8 women (31,4±2,6 years (M±σ)) with GP (according to Mannheim scale 30,1±3,2 year scores (M±σ)) where reamberin was not used.
Results. The use of reamberin in patients with GP reduces (60%) intensity of processes of free radical oxidation (FRO) and lipid peroxidation (LP) (reduction of MD (malonic dialdehyde in 2-fold), reduces the tissue hypoxia (in 3,8-fold). It generally contributes to the reduction of mortality, the terms of vasopressor support (in 1,5-fold), artificial pulmonary ventilation (APV) and decrease the hospitalization period of patients at the Intensive Care Unit (in 1,2-fold).
Conclusions. The conducted study confirms the efficiency of reamberin use in patients with GP due to its elimination of metabolic acidosis, improving the rheological properties of the blood and oxygen supply to the tissues at the expense of normalizing of the red blood cells volume, restoration of microcirculation, intestinal motility, realize an earlier enteral nutrition, improving of reparative processes and suturing of the laparotomic wound in the early postoperative period.

Keywords: reamberin, generalized peritonitis, intensive therapy, correction of rheological disorders, free radical oxidation, lipid peroxidation
p. 58 – 64 of the original issue
References
  1. Trubacheva OA, Shakhristova EV, Galich AI, Petrova IV. Vliianie povyshennoi Ca2+ zavisimoi kalievoi pronitsaemosti na deformiruemost' eritrotsitov [Effect of enhanced Ca2 + dependent potassium permeability on the erythrocyte deformability]. Vestn TGPU. 2011;5(107):69–72.
  2. Mal'tseva IV, Urazova OI, Novitskii VV, Shipulin VM, Chumakova SP, Khokhlov OA, Odintsova SE, Korchagina MV. Vliianie agregatsii eritrotsitov na vyrazhennost' vnutrisosudistogo gemoliza pri operatsiiakh v usloviiakh iskusstvennogo krovoobrashcheniia [Effect of red blood cell aggregation on the expression of intravascular hemolysis during operations under artificial circulation]. Gematol i Transfuziol. 2011;56(6):28–32.
  3. Moroz VV, Golubev AM, Chernysh AM, Kozlova EK. Izmenenie struktury poverkhnosti membran eritrotsitov pri dlitel'nom khranenii donorskoi krovi [Restructuring of erythrocyte membrane surface during prolonged storage of donor blood]. Obshch Reanimatol. 2012;(1)8:5–12.
  4. Shin S, Ku Y, Babu N, Singh M. Erythrocyte deformability and its variation in diabetes mellitus. Indian J Exp Biol. 2007 Jan;45(1):121–28.
  5. Fernandes CJ Jr. Red blood cell deformability is critical for oxygen utilization in sepsis. Crit Care Med. 2009 Dec;37(12):3172–3.
  6. Luk'ianova LD. Sovremennye problemy adaptatsii k gipoksii. Signal'nye mekhanizmy i ikh rol' v sistemnoi reguliatsii [ Current problems of adaptation to hypoxia. Signal mechanisms and their role in system regulation]. Patol Fiziol i Eksperiment Terapiia. 2011;(1):3–19.
  7. Luk'ianova LD, Germanova EL, Tsybina TA, Chernovaeva GN. Energotropnoe deistvie suktsinatsoderzhashchikh proizvodnykh 3-oksipiridina [Energotropic action of succinate-containing derivatives of 3-oxypyridine]. Biul Eksper Biol. 2009;148(10):388–92.
  8. Karmen NB, Abdulaeva MA, Tokareva LV. Sostoianie membran eritrotsitov pri khronicheskoi gipoksii [State of erythrocyte membranes in chronic hypoxia]. Anesteziol i Reanimatol. 2011;(5):58–62.
  9. Akman T, Akarsu M, Akpinar H, Resmi H, Taylan E. Erythrocyte deformability and oxidative stress in inflammatory bowel disease. Dig Dis Sci. 2012 Feb;57(2):458-64.
  10. Swihart AH, Mikrut JM, Ketterson JB, Macdonald RC. Atomic force microscopy of the erythrocyte membrane skeleton. J Microsc. 2001 Dec;204(Pt 3):212–25.
  11. Arslan M, Metin Comu F, Kucuk A, Ozturk L, Yaylak F. Dexmedetomidine protects against lipid peroxidation and erythrocyte deformability alterations in experimental hepatic ischemia reperfusion injury. Libyan J Med. 2012;7.
  12. Wang X, Wu Z, Song G, Wang H, Long M, Cai S. Effects of oxidative damage of membrane protein thiol groups on erythrocyte membrane viscoelasticities. Clin Hemorheol Microcirc. 1999;21(2):137–46.
  13. Kosinets VA. Primenenie reamberina v korrektsii funktsional'noi aktivnosti enterotsitov pri eksperimental'nom peritonite [Application reamberine in the correction of functional activity of enterocytes in experimental peritonitis] Eksperim i Klin Farmakol. 2010;73(2):35–38.
  14. Orlov IuP, Lukach VN, Filippov SI, Glushchenko AV, Maliuk AI, Pritykina TV, Parkhomenko KK, Petrova IuV. Effektivnost' i bezopasnost' sbalansirovannogo rastvora s antioksidantnoi napravlennost'iu reamberin v intensivnoi terapii peritonita i ostroi kishechnoi neprokhodimosti [The efficacy and safety of a balanced solution with the antioxidant oriented reamberin in intensive care of peritonitis and acute intestinal obstruction]. Khirurgiia Zhurn im NI Pirogova. 2012;(2):64–69.
  15. Dinkla S, Wessels K, Verdurmen WP, Tomelleri C, Cluitmans JC, Fransen J, Fuchs B, Schiller J, Joosten I, Brock R, Bosman GJ. Functional consequences of sphingomyelinase-induced changes in erythrocyte membrane structure. Cell Death Dis. 2012 Oct 18;3:e410.
Address for correspondence:
644119, Rossiiskaia Federatsiia, g. Omsk, ul. Pereleta d. 9, GKB ¹ 1, GBOU VPO Omskaia gosudarstvennaia meditsinskaia akademiia, kafedra anesteziologii i reanimatologii,
e-mail: orlov-up@mail.ru,
Orlov Yurii Petrovich
Information about the authors:
Orlov Y.P. MD, professor of the chair of anesthesiology and critical care medicine of SEI HPE "Omsk State Medical Academy".
Lukach V.N. An Honored Worker of Higher School, MD, a head of the department of anesthesiology and intensive care of SEI HPE "Omsk State Medical Academy".
Gluschenko A.V. PhD, an assistant of the chair of anesthesiology and intensive care of SEI HPE "Omsk State Medical Academy", a head of the intensive care unit for septic patients of Omsk Municipal Clinical Emergency Hospital.
Contacts | ©Vitebsk State Medical University, 2007-2023