Differentiated approach to antihypoxic and endoportal therapy in treatment of discharged peritonitis complicated by syndrome of intestinal insufficiency

Topchiev, Mikhail; Parshin, Dmitry; Кчибеков, Э. А.; Birukov, Petr; Misrikhanov, Misrikhan

doi:10.14300/mnnc.2018.13120

Cited by 6 publications

(6 citation statements)

References 2 publications

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“…EIT was carried out by introducing drugs through the catheter: meglumine sodium succinate 10 ml/kg/day, ciprofloxacin 400 mg/day and ademetionine 400 mg/day for 3-5 days at a rate of 60 drops per minute. There were no complications after catheterization and EIT [20].…”

Section: Methodsmentioning

confidence: 83%

“…Antihypoxants actively stimulate organ metabolism with the introduction of medicinal compositions (antibiotic, antihypoxant, hepatoprotector) into the portal bloodstream. It is assumed that EIT will make it possible to relieve intestinal failure syndrome at an earlier time, prevent the translocation of pathogens into the portal circulation and eliminate multiple organ failure [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Possibilities of Endoportal Infusion Therapy for Intra-Abdominal Surgical Infections Complicated by Acute Intestinal Failure

Parshin,

Mykhaylichenko,

Butyrskii

et al. 2024

ArveMED

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The purpose of this study was to evaluate the effectiveness of EIT for intra-abdominal infections complicated by acute intestinal failure. Materials and Methods: The authors modified the technique of catheterization of the right gastroepiploic vein to conduct prolonged endoportal infusion therapy. The modification allows for easy surgery and successful removal of the catheter upon completion of endoportal infusion therapy. This operation is possible using video laparoscopic access. An antihypoxic agent, an antibiotic, and a hepatoprotector were given as an endoportal bolus. The technique was carried out on 24 patients with various purulent-inflammatory diseases of the abdominal organs complicated by acute intestinal failure. The results were compared with a group of 24 patients treated with traditional methods. Research Results: As a result of the study, it turned out that in the main group, indicators returned to normal according to the systems for assessing the severity of the condition (APACHE II and abdominal index) and signs of intestinal failure (EMFC) on the day 5 of treatment. At the same time, in the comparison group, these changes occurred only on the day 7 of treatment (p≤0.05). The values of enzymes reflecting the state of the intestinal wall, as well as indicators of cellular immunity were normalized by day 3 in the main group, and by day 7 in the comparison group (p≤0.05). Conclusion: The proposed EIT technology can serve as a good supplement to the treatment of patients with intra-abdominal purulent-inflammatory diseases complicated by acute intestinal failure. It prevents bacterial translocation into the portal system and thus reduces the risk of generalized infection and multiple organ failure.

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Section: Methodsmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Possibilities of Endoportal Infusion Therapy for Intra-Abdominal Surgical Infections Complicated by Acute Intestinal Failure

Parshin,

Mykhaylichenko,

Butyrskii

et al. 2024

ArveMED

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“…EPT was carried out by introducing drugs through a catheter: meglumine sodium succinate 10 ml/kg/day, ciprofloxacin 400 mg/day and ademetionine 400 mg/day for 3-5 days at a rate of 60 drops per minute. There were no complications after catheterization and endoportal infusions [35].…”

Section: Methodsmentioning

confidence: 86%

“…In addition, there are earlier studies on the effectiveness of oxygenated water in anaerobic infection. Probably one of the effects is the creation of unfavorable conditions for the growth and reproduction of obligate anaerobes [25,26]. The data obtained require further study.…”

Section: Intoductionmentioning

confidence: 99%

Differentiated Approach to Antihypoxic, Endoportal and Phage Therapy for Advanced Purulent Peritonitis

Parshin,

Mykhaylichenko,

Mukaramov

et al. 2024

ArveMED

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The purpose of this study was to evaluate the results of differentiated use of enteral antihypoxic therapy (EAT), endoportal therapy (EPT), as well as phage therapy (PT) in patients with diffuse purulent peritonitis complicated by acute intestinal failure (AIF). Materials and Methods: 144 patients with diffuse peritonitis and AIF were treated. The patients were divided into two equal comparable groups: main (n=72) and comparison (n=72). In addition, each group was divided into three subgroups (24 patients each) depending on the degree of AIF. The groups were distributed using adaptive randomization. EAT was carried out by introducing oxygenated water through a nasogastrointestinal (NGI) tube. EPT was carried out by introducing an antibiotic, a hepatoprotector and an antihypoxant through a catheter into the portal system. PT was carried out by introducing a polyvalent bacteriophage through a NGI tube. The following were dynamically studied: EMFC, APACHE II, abdominal cavity index (ACI), acid-base status and blood gas composition, integral intestinal pressure (IIP), intra-abdominal pressure (IAP). Comparison of quantitative indicators in the study groups was carried out using the Wilcoxon-Mann-Whitney U test, as well as its multivariate generalization - the Kruskal-Wallis test, for checking the equality of medians of several samples. Results: The dynamic study of IIP and IAP in the study groups on the day 3 of treatment, showed significantly lower values in the main group (p≤0.05). There was a more rapid decrease in the manifestations of hypoxia in the main group, which was confirmed by an increase in the oxygen partial pressure in the blood. The average number of bed days in the intensive care unit was 4.2±0.3 days in the comparison group, and 3.3±0.2 days in the study group. The overall average number of bed-days was 15.8 in the study group, and 18.5 in the comparison group. Mortality was 16.3% in the comparison group, and 11.3% in the study group (a decrease of 30.7%). Thus, when prescribing NGI, EAT, EPT and PT, one should be guided by the severity of organ dysfunction and the AIF stage. With values of ACI <13, APACHE II <10 and EMFC <5, NGI and EAT are indicated. With ACI 14-22, APACHE II 10-15, EMFC 5-25 - NGI and EAT are supplemented with PT. In the most severe cases, with ACI ≥23, APACHE II >16 and EMFC >25 points, EPT must be added to the above treatment methods. Conclusion: The proposed scheme for the differentiated use of EPT, EAT and PT in patients with diffuse peritonitis complicated by AIF allows to relatively quickly stop inflammation and prevent the development of multiple organ failure and sepsis.

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“…Воздействие на бактериальное заражение в тонком кишечнике реализуется в основном эмпирической системной антибиотикотерапией, которая зачастую является неэффективной. Имеются обнадеживающие результаты по внутрикишечному использованию энтеропротекторов, сорбентов и антигипоксических препаратов, однако они зачастую не учитывают степень выраженности ОЭН, а также сформированный патобиом [17][18][19]. Несмотря на очевидную актуальность, исследований, посвященных изучению энтерального патобиома при ОЭН, очень мало.…”

Section: ключевые слова: фаговая терапия поливалентные бактериофаги о...unclassified

The clinical and experimental substantiation of bacteriophages and oxygenated preparation application in disseminated peritonitis complicated with enteral insufficiency

Topchiev¹,

Parshin²,

Misrikhanov³

et al. 2022

Medical news of the North Caucasus

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8. Лубянский В. Г., Сероштанов В. В. Результаты дуоденумсохраняющих резекций поджелудочной железы при хроническом панкреатите с применением технологий герметизации панкреатокишечного анастомоза. Acta Biomedica Scientifica. 2019;4(2):122-126. [Lubyanskii V. G., Seroshtanov V. V. The results of duodenum-preserving resections of the pancreas in chronic pancreatitis using the technology of sealing the pancreatic-intestinal anastomosis. Acta Biomedica Scientifica. 2019;4(2):122-126. (In Russ.)].

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Differentiated approach to antihypoxic and endoportal therapy in treatment of discharged peritonitis complicated by syndrome of intestinal insufficiency

Cited by 6 publications

References 2 publications

Possibilities of Endoportal Infusion Therapy for Intra-Abdominal Surgical Infections Complicated by Acute Intestinal Failure

Possibilities of Endoportal Infusion Therapy for Intra-Abdominal Surgical Infections Complicated by Acute Intestinal Failure

Differentiated Approach to Antihypoxic, Endoportal and Phage Therapy for Advanced Purulent Peritonitis

The clinical and experimental substantiation of bacteriophages and oxygenated preparation application in disseminated peritonitis complicated with enteral insufficiency

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