Sepsis-3: renewed determinations, potential problems and further practical foot steps

Кryvoruchko, І. А.; Boyko, V. V.; Ivanova, Yu. V.; Аndreieshchev, S. А.

doi:10.26779/2522-1396.2019.06.60

Cited by 3 publications

(5 citation statements)

References 71 publications

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“…The level of catabolic processes is increasing sharply, while the overall energy potential is reduced. Thus, in the pathogenesis of general disorders in the inflammation of the peritoneum, two processes occupy the main place: progressive endotoxicosis and metabolic disorders at all levels, which are closely interrelated and mutually enhance their action [7].…”

Section: Questions Of Gastrointestinal Tractmentioning

confidence: 99%

“…Changes in intracellular metabolism are known to be closely related to the physicochemical properties of membranes and are observed in diabetes, atherosclerosis, chemical intoxication, radiation exposure, emotional stress, tumor growth, and more. There is enough evidence that harmful factors of endogenous and exogenous origin are able to stimulate free radical reactions in the body, peroxidation of lipids, oxidative modification of proteins, nucleic acids [7][8][9].…”

Section: Questions Of Gastrointestinal Tractmentioning

confidence: 99%

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Study of Electrolyte Disorders as Criterion-Important Markers of Endogenous Intoxication in Patients With Anastomosis Leakege Against a Background of Resection of the Small Intestine

Tymchenko¹

2020

Khark. Surg. Sch.

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Summary. The aim of the study was to study the dependence of ion exchange and saturation with iron transferrin on the background of increasing endotoxicosis, depending on the severity of the clinical course of acute small bowel obstruction and peritonitis. Materials and methods. The research was carried out at the SI «ZIGUS NAMSU» and was based on the analysis of laboratory data of 63 patients with a failure of small intestinal anastomoses who in the future needed one of the options of resections of the segments of the small intestine, which were treated in the clinic from 2016 to 2019. All patients were divided into 3 groups according to the degree of physical severity of the condition on the APACHE II scale. The study was conducted in two stages: the first stage examined the content of zinc, copper and iron ions in the serum of all patients studied, the second stage of the study in patients evaluated the objective indicators of endogenous intoxication on the basis of leukocyte index of intoxication, index of content molecular weight, malonic aldehyde and diene conjugates in serum and iron levels in whole blood, as well as its serum. Results and Discussion. The study of Fe2+, Zn2+, Cu2+ metabolism in the serum of all patients with inflammatory phenomena of the peritoneum on the background of anastomosis failure revealed significant changes. In the clinical group of patients with small bowel anastomosis, the level of zinc upon admission to the hospital was significantly increased. In the second stage, we conducted a study on the detection of an increase in serum iron content, endogenous intoxication and a decrease in transferrin iron saturation depending on the clinical course of the disease in patients with acute intestinal obstruction and peritonitis and the degree of contamination of the small intestine. The results shown in study indicate that in the studied patients, depending on the severity of the disease there is a progressive decrease in the content of iron in whole blood, along with an increase in its serum level against the background of a significant decrease in iron saturation and increase in objective indicators of endogenous intoxication. Conclusions. On the basis of the results of the research, we can conclude that the increase of serum iron content with simultaneous decrease of transferrin iron saturation in the studied patients on the background of intensification of endotoxicosis depending on the severity of the condition, considering it as a factor of increasing the aggressiveness of bacterial resistance and flora correlates with the severity of the clinical course, according to which appropriate adequate additional corrective therapy is performed in complex surgery. treatment of patients with a small bowel anastomosis.

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Section: Questions Of Gastrointestinal Tractmentioning

confidence: 99%

Section: Questions Of Gastrointestinal Tractmentioning

confidence: 99%

Study of Electrolyte Disorders as Criterion-Important Markers of Endogenous Intoxication in Patients With Anastomosis Leakege Against a Background of Resection of the Small Intestine

Tymchenko¹

2020

Khark. Surg. Sch.

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“…In 15-25 %, the course of urgent surgical diseases is complicated by peritonitis. Mortality in common forms of peritonitis, according to different authors, ranges from 10 to 60 %, and in hospital peritonitis it can reach 90 % [1,2,3].…”

Section: Introductionmentioning

confidence: 99%

Prevention of Early Postoperative Complications of Intestinal Surgery Using Immunomodulating Therapy

Tymchenko¹

2020

Khark. Surg. Sch.

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Summary. The aim of the study is to develop a method of immunocorrection, which improves the results of treatment of patients with developed peritonitis against the background of the small intestine anastomosis leakege by stopping the cascade of SIRS and MOF. Materials and methods. The work was clinical in nature, was performed in the clinic of the SI «ZIGUS NAMSU» in the period from 2016 to 2019. We examined 58 patients with various diseases of the abdominal organs complicated by peritonitis, in which sections of the small intestine were resected. The Comparison Group included patients who received traditional therapy, patients of the Main Group, the complex of drug therapy included recombinant interleukin-2, galavit and α-lipoic acid. The results of surgical treatment were evaluated according to the classification of D. Dindo, N. Demartinesta, P.-A. Clavien (2004). Statistical analysis was removed from the Statistica 6.0 software (StatSoft, Inc. 2001) and SPSS 7.5 on Apple PC. Results and Discussion. Thus, the results of the use of a comprehensive immunomodulation scheme using IL-2, galavit and α-lipoic acid in the complex treatment of patients with widespread peritonitis against the background of intestinal anastomosis failure suggest that the developed scheme has a targeted immunoregulatory effect and prevents the excess production of inflammatory mediators in the early postoperative the period of the disease, helps to eliminate the cytokine imbalance and prevents the development of secondary immune deficiency. A comparative analysis of the incidence of complications revealed that in patients of the Main Group the average number of complications per patient was 0.53, while in the Comparison Group this indicator was 1.36. Conclusions. The use of a combination of IL-2, galavit and α-lipoic acid in the complex of treatment of common peritonitis helps to reduce the level of systemic and local postoperative complications, as well as the level of postoperative mortality.

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“…It confirms the bacterial origin of the mitochondria. In mitochondria, as in bacteria, the nuclear genome DNA sections are not methylated [59].…”

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confidence: 99%

“…Endotoxin is able to activate endotoxin-binding protein of plasma, leading to stimulation of CD14 receptor structures on cells of the monocyte-macrophage system, that is, the so-called pattern receptors. In this processing a splitting off from the CD-14 monocyte /macrophage receptor complex and the formation of presepsin is carried out [59]. Presepsin is used as a biomarker of infectious sepsis [32].…”

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confidence: 99%

Abdominal Sepsis. Some Genetic-Molecular Mechanisms of Its Occurrence

Kavyn

2020

Galician med. j.

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Sepsis is a dangerous pathology which is characterized by a high mortality and morbidity in the whole world. Among varieties of sepsis an abdominal sepsis takes the second position. A huge number of scientific investigations, dedicated to sepsis, were done and are being done now. The search for new pathophysiological links of sepsis is ongoing. Studies show that more and more scientists pay attention to the status of genes polymorphism and their influence on the molecular mechanisms of the course of abdominal sepsis, which can help to decide this complex medical problem.

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Sepsis-3: renewed determinations, potential problems and further practical foot steps

Abstract: Sepsis-3: renewed determinations, potential problems and further practical foot steps

Cited by 3 publications

References 71 publications

Study of Electrolyte Disorders as Criterion-Important Markers of Endogenous Intoxication in Patients With Anastomosis Leakege Against a Background of Resection of the Small Intestine

Study of Electrolyte Disorders as Criterion-Important Markers of Endogenous Intoxication in Patients With Anastomosis Leakege Against a Background of Resection of the Small Intestine

Prevention of Early Postoperative Complications of Intestinal Surgery Using Immunomodulating Therapy

Abdominal Sepsis. Some Genetic-Molecular Mechanisms of Its Occurrence

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