Purpose.To evaluate the role of ozonized erythrocytic mass transfusion in the restoration of damages in the architectonics of myocardium microvasculature and cardiomyocytes in case of a severe blood loss.Materials and Methods. Two batches of experiments were conducted, 17 white outbred rats in each. The animals were anesthetized with thiopental sodium (25 mg/kg). Blood loss was caused by taking 3ml of blood from the tail artery of rats, which is 35% of the circulating blood volume. One hour after the blood loss, transfusion of autoerythrocytes with normal saline solution and Ringer’s solution infusion in 1:1 ratio was performed in the control batch. In the experimental batch, 3 ml of autoerythrocytes treated with ozonized saline solution with ozone concentration of 2 mg/l and 3 ml of Ringer’s solution (1:1 ratio) were administered to rats. Erythrocyte mass was prepared from 3 ml of the autoblood harvested from the animals 3 days before the experiment. On a post-transfusion day5, in both batches and in five intact animals, hearts were removed following the intraperitoneal thiopental sodium injection (100 mg/kg). The left ventricle wall specimen from each heart was removed for examination. Histologic sections were stained with hematoxylin and eosin. The preparations were visually examined and morphometric studies were performed using microvisor Vizo-103.Results.It has been established that administration of ozonized erythrocyte for severe blood loss correction limited the decrease in numbers of capillary profiles and their diameters, formation of mixed and hyaline thrombi fully or partially occluding microvascular lumens, major hemorrhages and reduction of variation of nuclear profiles, decreased perivascular, pericellular, perinuclear, and endonuclear edema of myocardial tissue, cardiomyocyte overcontruction zone, and their ruptures.Conclusion.The positive trends for microcirculation indices, vascularization density and myocardial edematization as prognostic markers in assessing potential posthypoxic rehabilitation of damaged tissues upon blood loss correction with ozonized erythrocyte mass might be explained by the antihypoxic, antioxidant, and detoxifying actions of ozone on erythrocytes and/or its metabolites (ozonides) in the body post-transfusion.
1 7 , 1 3 ; 2 24 w w w . r e a n i m a t o l o g y . c o mЦель исследования: изучить влияние инфузии этилетилгидроксипиридинасукцината (ЭМГПС) на ди намику паттернов мозгового кровотока у пострадавших в остром периоде тяжелой сочетанной черепно моз говой травмы.Материалы и методы исследования. Обследовали 2 группы больных по 25 человек в каждой с тяжелой сочетанной ЧМТ. Средний возраст составил 41,5 (29; 51) лет. Больным в 1 й группе (контрольной) прово дили стандартную интенсивную терапию, а во 2 й группе (исследуемой) дополнительно к стандартному ле чению проводили инфузию ЭМГПС в дозе 100 мг/час через инфузомат на протяжении 10 суток. Методи кой транскраниальной допплерографии (ТДГ) изучали показатели церебральной макроциркуляции (ПЦМ): систолическую скорость кровотока (V max ), диастолическую скорость кровотока (V min ), пульсацион ный индекс (PI) и индекс сопротивления (RI).Результаты исследования. В обеих группах наиболее частым видом нарушения мозгового кровотока (МК) при первичном исследовании был паттерн затрудненной перфузии: 15 и 16 случаев в 1 й и 2 й груп пах, соответственно. В 1 й группе в 4, а во 2 й в 3 случаях отмечали наличие мягкого ангиоспазма, а в 2 слу чаях в каждой группе отмечали признаки грубого ангиоспазма. У 2 больных в каждой группе отмечали пат терны гипоперфузии и гиперперфузии. У пациентов в 1 й группе на 3 е сутки исследования нормализация ПЦМ наблюдалась в 6, на 5 е сутки -в 8, на 7 е сутки -в 12, на 10 сутки -в 18 случаев, в то время, как у пациентов во 2 й группе на 3 е сутки нормализация ПЦМ наблюдалась в 12, на 5 е сутки -в 15, на 7 е сут ки -в 16, на 10 е сутки -в 20 случаях.Заключение. Чаще всего при первичном обследовании выявлялись паттерны затрудненной перфузии и ангиоспазма, которые трансформировались в паттерн нормоперфузии через стадию гиперперфузии (реак тивной гиперемии). Инфузия ЭМГПС в дозе 100 мг в час способствует нормализации параметров ПЦМ уже к 3-5 суткам. Ключевые слова: черепно мозговая травма; церебральная макроциркуляция; паттерны мозгового крово тока; этилметилгидроксипиридина сукцинатThe purpose of the investigation was to study the effect of the ethylmethylhydroxypyridine succinate (EMHPS) infusion on the dynamics of cerebral blood flow patterns in patients during the acute phase of severe concomitant traumatic brain injury.Materials and methods. The study involved two groups of patients, each of 25 persons aged 41.5 (29; 51) years on average, with a severe concomitant traumatic brain injury. The patients of the 1 st (control) group were cured with a standard intensive care while in the 2 nd (study) group the EMHPS infusion was added to the said standard treatment in a dose of 100 mg per hour through an infusion pump within 10 days. By transcranial dopplerography (TDG) testing the following cerebral macrocirculation parameters (CMP) were studied: systolic blood flow veloc ity (V max ), diastolic blood flow velocity (V min ), pulsation index (PI) and resistance index (RI). Влияние этилметилгидроксипиридина сукцината ВведениеИзучение механизмов защиты ...
Purpose of the study: to investigate the influence of hypovolemia correction by infusion of malate-containing preparations and subsequent glutamine-enriched nutritional support on the maintenance of gut barrier and overhydration in animals with acute massive blood loss/ Materials and methods. Blood samples were harvested from the tail and portal veins of rats (n=100) at different time points after the acute blood loss (>30% V/V) . Bacterial blood cultures for growth, lipopolysaccharide and presepsin concentrations, colon structures and animal weight were analyzed in blood and plasma specimens 1 hour, one day and 3 days after the hypovolemia correction. To correct the hypovolemia, in the 1st series of experiments, the Ringer’s solution and standard nutrient mixture were used; in the 2nd series malatecontaining solution and standard nutrient mixture were administered; in the 3rd series a malate-containing solution and glutamine-enriched nutrient mixture were employed.Results. In the portal vein blood of intact animals, endotoxin measurement was equal to 17.8Ѓ}3.9 pg/ml, that of presepsin — 405.6Ѓ}80.1 pg/ml. At all stages, tail and portal blood bacterial cultures were negative demonstrating an absence of bacterial growth and gut barrier intactness for live microorganisms. One hour after hypovolemia correction and blood reinfusion, multifold increase in endotoxin concentration in the blood from both portal and tail veins was accompanied by significant increase of presepsin concentration. 24 hours after the blood loss, in the animals of the 2nd and 3rd series, the levels of endotoxin, presepsin, and edema of the colon mucous membrane and submucosal space has become lower than those in the 1st series. Three days later, the advantages of glutamine-containing nutrition in the 3rd series of the experiment were determined that revealed decreasing the endotoxin and presepsin concentrations in the portal and tail vein blood and diminishing the levels of interstitial edema of colon and animal weight growth.Conclusion. Administration of malate-containing infusion preparations and glutamine-enriched nutrition after an acute massive blood loss contributes to decreasing presepsin production in GIT organs, abrogating endotoxin translocation into the portal vein and systemic circulation, lessening severity of edema of the mucous membrane and submucosal space of the colon, and reducing the previously increased animal body mass.
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