Action of cold on the organism. Cryoprotectors and means of anti-ischemic tissue protection

Целуйко, С. С.; Zabolotskikh, T.V.; Dudarikov, S.A.; Красавина, Н. П.; Korneeva, L.S.

doi:10.25789/ymj.2018.62.15

Cited by 3 publications

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“…Установлена обратная умеренная связь по шкале Чеддока между скоростью распространения возбуждения и показателем шунтирования (r = -0,3, p < 0,001). Прямой сброс крови из артерии в вену, минуя капиллярное русло, провоцирует значительное снижение артериального давления в капиллярах и уменьшению напряжения сдвига [2,4]. Компенсаторно активированные эндотелиальные клетки про-дуцируют значительное количество вазоконстрикторов, еще более усугубляя вазоспазм и локальное воспаление.…”

Section: Discussionunclassified

“…Местная холодовая травма в общей структуре травматических повреждений в мирное время в зоне с умеренным климатом составляет около 1%, а в Сибири, на Дальнем Востоке и в Северных регионах достигает 6-20% [1,2]. Актуальность криопоражений обусловлена большим числом пострадавших, сложностью лечения, длительной утратой трудоспособности, тяжелыми последствиями и, как следствие, высоким уровнем инвалидизации.…”

Section: Introductionunclassified

“…При этом течение раневого процесса чаще всего сопровождается развитием осложнений, увеличением сроков и характера комплексного лечения [3][4][5]. Последние годы отмечены расширением исследований отечественных и зарубежных авторов по вопросам ранней диагностики глубины поражения тканей и прогнозирования исходов местной холодовой травмы [2]. У большинства специалистов не вызывает сомнений ведущая роль нарушений кровообращения и иннервации в патогенезе отморожений [1,2,6,7].…”

Section: Introductionunclassified

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Comprehensive assessment of peripheral innervation and microcirculatory function in local cold trauma

Михайличенко¹,

Шаповалов²,

Mudrov³

2021

Zhurnal «Patologicheskaia Fiziologiia I Eksperimental`naia Terapiia»

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Актуальность криопоражений обусловлена большим числом пострадавших, сложностью лечения, длительной утратой трудоспособности, тяжелыми последствиями и, как следствие, высоким уровнем инвалидизации. Цель исследования -- оценка изменений микрокровотока и периферической иннервации при местной холодовой травме и формирование прогностической модели уровня повреждения конечности. Методика. Под наблюдением было 35 больных с местной холодовой травмой нижних конечностей III-IV степени. Использован неинвазивный метод лазерной доплеровской флуометрии с помощью аппарата ЛАКК-02, а также метод накожной электронейромиографии с помощью аппарата Нейро-ВМП, компании Нейрософт. Результаты. Несмотря на гипотетически функциональную связь между микрокровотоком кожи и уровнем отморожения пораженной конечности, статистически значимых результатов получено не было (p > 0,05), что свидетельствует о более сложном генезе патологических изменений в пораженной конечности. Между тем, у пострадавших с местной криотравмой отмечены выраженные изменения периферической иннервации. Нейропатия прогрессирует с увеличением уровня повреждения. Заключение. У пациентов с местной холодовой травмой отмечается снижение биоэлектрической активности мышц в области пораженной конечности. Cryotrauma is relevant due to a large number of patients, the complexity of treatment, the likelihood of severe complications, and long-term disability. The aim was to assess oscillations in microcirculation and peripheral innervation during regional cold injury, and to form a prognostic model according to the severity of limb injury. Methods. Studies were carried out in 35 patients with III-IV degree local cold injury of a leg. Non-invasive laser Doppler flowmetry was performed with a LAKK-02 device, and peripheral innervation was evaluated by cutaneous electroneuromyography with a Neurosoft Neuro-VMP device. The patients were divided into 3 groups depending on the injury. Results. Despite the hypothetical, functional relationship between skin microcirculatory blood flow and the degree of frostbite of the affected tissue, no statistically significant association was detected (p > 0.05), which indicates a more complex genesis of the cold-induced pathology. However, there were pronounced changes in neural activity in this tissue. Neuropathy increased with increasing injury. Conclusions. In patients with local cold trauma there is a decrease in the bioelectric activity of the muscles in the damaged tissue.

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Section: Discussionunclassified

Section: Introductionunclassified

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Comprehensive assessment of peripheral innervation and microcirculatory function in local cold trauma

Михайличенко¹,

Шаповалов²,

Mudrov³

2021

Zhurnal «Patologicheskaia Fiziologiia I Eksperimental`naia Terapiia»

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Features of disturbances of microcirculation and intercellular interactions in local cold injury

Михайличенко

Шаповалов

Mudrov

et al. 2020

Regional blood circulation and microcirculation

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The aim of the work is to evaluate microcirculation, innervation and intercellular interactions depending on the severity and timing of cold tissue lesions. Materials and methods. 50 patients with III–IV degree of lower extremities local cold injury, as well as their blood were explored. Patients were divided into two groups depending on the period of clinical course: 5 and 30 days of cold injury. At the same time, the patients were divided into 3 groups according to the level of the lesion. The 1 group patients had only fingers frostbitten. Group 2 – patients had lesion boundary extended to the metatarsals and metatarsals. Patients with cold trauma of the proximal segments of the lower extremities belonged to group 3, had the damage level limited by the lower third of the low leg in the most cases. Studies in these groups were carried out on the 5th day after the injury. The phenomenon of lymphocytic-platelet rosette formation and the amplitude of M-response were evaluated. Results. In patients with frostbite, the increased adhesive ability of blood platelets to lymphocytes, was significantly decreased by 30 days. By the day 5, the number of lymphocyte-platelet rosettes increased 2.2 times, and the degree of adhesion 1.7 times. By the day 5 of the injury, the value of the M-response was reduced by 1.7, and the detected changes were preserved for day 30. In patients with fingers frostbitten, the percentage of LTA increased by 1.3 times, and the degree of adhesion by 1.5 times. Registered ENMG potentials decreased by 1.7 times. In group 2, the ability of platelets to adhere to lymphocytes increased by 1.6 times, and the average number of plates participated in rosette formation increased by 2.1. The registered ENMG potentials decreased by 2.5 times. In patients with the maximum level of cold tissue damage, the adhesive ability of lymphocytes and platelets increased by 3 times, and the degree of adhesion increased by 3.5 times, the amplitude of the M-response decreased by 2.6 times. Conclusions. The patients with local cold injury have been demonstrated the increasing of the platelets ability to adhesion to lymphocytes. The increasing of the number and degree of LTA was proportional to the level of tissues damaged by cold. Also, patients with frostbite had a sharp decreasing of in the amplitude of the M-response (motor response), which was getting worse with the increasing of severity of tissue damage. In the case of local cold injury, the maximum activity deviations in the activity of lymphocytic-lamellar interactions and the m-response amplitude of the electroneuromyography were recorded in the early period of cold injury, with a tendency to restore the wound process on the 30th day.

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Dynamics of Matrix Metalloproteinases in Local Cold Injury

Михайличенко

Шаповалов

Mudrov

et al. 2019

Acta biomedica scientifica

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The relevance of cold injury is due to its high specific weight in the structure of injuries, complexities of complex therapy, and unsatisfactory results of treatment. It is known that in the pathogenesis of local cold injury, the leading role belongs to endothelial dysfunction, which secretes a huge amount of biologically active substances, including matrix metalloproteinases.Aim: to determine the dynamics of the content of matrix metalloproteinases of the second subfamily (MMP-2, MMP-9) in the serum of patients with local cold injury.Materials and methods. The study included 80 patients (60 men, 20 women) with frostbite of the III–IV degree of the foot to the level of the lower third of the leg in the late reactive period and the period of granulation and epithelization.Results. In the late reactive period in patients with cryopreservation, the level of MMP-2 was 3.4 times higher relative to the control (p = 0.011), on day 30 MMP-2 values did not differ from the control parameters (p = 0.103). The level of collagenase B (MMP-9) in patients with local cold injury on day 5 was 14.5 times higher than the control parameters (p = 0.002), on day 30 – 12.5 times higher compared to the control group (p = 0.000094).Conclusion. During the analysis of the data obtained, we can think about the dual nature of collagenases during the processes of inflammation. In a situation of distress, collagenases prevent endothelial dysfunction by eliminating the cellular structures of the endothelium to ensure adequate metabolism in tissues. Their importance as markers of failure of adequate flow of reparative processes is not excluded.

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Action of cold on the organism. Cryoprotectors and means of anti-ischemic tissue protection

Cited by 3 publications

References 0 publications

Comprehensive assessment of peripheral innervation and microcirculatory function in local cold trauma

Comprehensive assessment of peripheral innervation and microcirculatory function in local cold trauma

Features of disturbances of microcirculation and intercellular interactions in local cold injury

Dynamics of Matrix Metalloproteinases in Local Cold Injury

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