Intestinal alkaline phosphatase — a biomarker of the degree of acute enteralinsufficiency in urgent surgery

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.

Section: Resultsmentioning

confidence: 99%

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

Parshin,

Mykhaylichenko,

Butyrskii

et al. 2024

“…Figure 1. Change in the transluminal enteral pathobiome in study groups (×10 [1][2][3][4][5][6][7][8][9][10] CFU in 1 мl)…”

Section: Results Of the Study And Their Discussionmentioning

confidence: 99%

Polyvalent Bacteriophages and Oxygenated Water – Possibilities for Prevention of Surgical Site Infection During Emergency Abdominal Surgery

Parshin,

Mykhaylichenko,

Kupriyanov

et al. 2023

We carried out a single-center study of the effectiveness of polyvalent bacteriophages and oxygenated water for the prevention of SSI. The object was 88 patients who had undergone abdominal surgery for emergency abdominal pathology with a high risk of SSI >30±3% (ACS NSQIP). Phages were administered topically and enterally, while OW only enterally. As a result of the study, it turned out that the combined use of PVBP and OW allows to normalize the induced enteral pathobiome, to reduce pathogen contamination, to enhance the protective capabilities of enterocytes, to stop intestinal failure in the early stages and to reduce the risk of SSI by more than 2 times.

“…These cross coupling interactions have a great influence on the formation of the function of the host's immune system and, ultimately, on the outcome of interventions. Evidence suggests that pathogens derived from the gut microbiota can cause postoperative infection while they stealthily travel inside an immune cell and contaminate a remote surgical site (Trojan horse hypothesis) [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Results of the Use of Polyvalent Bacteriophages in the Treatment of Infectious Complications in Emergency Abdominal Surgery

Parshin,

Mykhaylichenko,

Kupriyanov

et al. 2023

We comparatively studied the results of treatment of 86 patients with surgical infectious complications after cavitary intra-abdominal operations for emergency abdominal diseases. In the main group, treatment was supplemented with polyvalent bacteriophages. We studied integral scales for assessing the severity of patient’s condition of (APACHE II, ACI, ASEPSIS), microbial pattern, enteral morphofunctional coefficient, levels of alkaline phosphatase and intestinal alkaline phosphatase, and indicators of cellular immunity. The results of the study show that complex treatment including polyvalent bacteriophages in postoperative purulent-inflammatory complications in urgent surgery reduces the development of antibiotic-resistant strains, as well as the risk of nosocomial microbial wound associations. Enteral application of polyvalent bacteriophages in patients with acute intestinal failure syndrome normalizes microbial enteral imbalance and the level of pathogens contamination of the small intestine. Supplementing the treatment of postoperative abdominal purulent-inflammatory complications with phage therapy can reduce the number of surgical interventions, as well as the treatment duration and mortality.