Clinical effectiveness of phospholipids in patients with restrictive respiratory failure due to lung tissue inflammation

Abstract

Objective — to analyze the clinical effectiveness use of phosphatidylcholine liposomes in the treatment of patients with restrictive respiratory failure caused by acute pneumonia and pneumonia with a prolonged course.
 Materials and methods. A prospective cohort study of 68 people was conducted on the basis of the pulmonology department of the Kirovohrad Regional Hospital of the Kirovohrad Regional State in 2020—2021. The people were divided into two groups: I (n = 20) — control group, II (n = 48) — experimental group. They were composed of men aged 25 to 40 years. The first group consisted of healthy individuals who underwent a preventive examination. The second group included patients who, in addition to the traditional treatment of pneumonia, were treated with phospholipids in liposomal form. The drug was used by inhalation according to the instructions. In the course of the experiment, the volume-time indicators of external respiration and gas exchange of the body were studied in dynamics.
 Results and discussion. The introduction of phospholipids in liposomal form had a positive effect on the restoration of the function of external respiration from the 5th day of treatment of the disease. This is evidenced by the gradual normalization of breathing rate and respiratory volume. It was shown that the ratio of alveolar ventilation and minute respiratory volume was significantly lower and ranged from 60.3 to 72.7 % (with a control value of 72.2 to 77.4 %). Oxygen consumption increased by approximately 76 % on the 5th day of the disease, which indicates a pronounced increase in the level of oxidative metabolism in the body during this pathological process. Recovery could be observed due to optimization of the body’s oxygen supply. Regarding carbon dioxide release, this indicator was almost 2.3 times higher than the control values ​​on the 5th day of the disease. This contributes to the development of metabolic acidosis, which in turn leads to respiratory alkalosis. Against the background of phosphatidylcholine liposomes treatment, this indicator gradually decreased and had a tendency to approach control values ​​a month after treatment (0.216 ± ± 0.042) l/min). Another of the studied indicators is the dead breathing space. According to this indicator, the efficiency of external breathing also increased. The minute volume of blood flow in healthy individuals was (6.5 ± 0.7). During the disease, it decreased to (4.7 ± 0.8) with gradual recovery, starting from the 10th day of treatment with phospholipids. There is also a decrease in the oxygen saturation of the arterial blood and a decrease in the use of oxygen, which can be judged by the characteristics of the venous blood; at the same time, the determined oxygen consumption increases due to hyperventilation. One month after the treatment, these indicators were no longer significantly different from the control values. A similar trend is noted in the analysis of oxygen tension in arterial and venous blood, with a gradual normalization of indicators against the background of the use of phosphatidylcholine liposomes. The determination of the alveolar-arterial difference in oxygen showed an increase in the indicator in the experimental group compared to the control group. Most of the indicators we studied contributed to the decrease in oxygen, thus increasing the efficiency of external respiration.
 Conclusions. Phosphatidylcholine liposomes are an effective means of complex therapy of pneumonia. The drug has a normalizing effect on the level of energy metabolism in the body and normalizes oxygen consumption, contributing to a faster recovery of the optimal intensity of metabolic processes.