Features of the composition of certain complex hyperosmolar infusion solutions

Abstract

Objective. To justify the use of complex hyperosmolar solutions.
 Results and discussion. Today, the question of the qualitative composition and quantitative relationship between the various components of infusion-transfusion therapy remains controversial. Hypertonic solutions in various concentrations of NaCl were first used for “low-volume resuscitation” in patients with hemorrhagic shock. Administration of these solutions results in a temporary osmotic pressure gradient between the blood plasma and the interstitial space, causing fluid to move into the intravascular space, increasing cardiac output, blood pressure, and improving microcirculation. Recently, combinations of hypertonic NaCl with colloids, as well as multicomponent infusion drugs are increasingly used. These are, in particular, the drugs Rheosorbilact, Xylate, Lactoxyl, Sorbilact, Lactoprotein with sorbitol, Gecoton developed at the Institute of Blood Pathology and Transfusion Medicine of the National Academy of Medical Sciences of Ukraine. Preparations based on polyhydric alcohols of sorbitol or xylitol, alkalizing agents of sodium lactate or sodium acetate and electrolytes. Rheosorbilact, Xylate, Lactoxyl are basic solutions for detoxification therapy, including in patients with diabetes. Sorbilact used as an osmodiuretic and for the treatment of patients in the postoperative period. Protein-salt solution based on donor albumin Lactoprotein with sorbitol is a mean for intensive care in emergencies. Colloid-hyperosmolar infusion solution Gecoton based on hydroxyethyl starch is used as a mean for low-volume resuscitation in the prehospital stage, including combat victims. Specially selected substances comprising the combined drugs affect different parts of the pathological process and have several advantages compared to mono-drugs. The pharmacological action of such solutions is due to the mutual potentiation of the action of its components. This provides hemodynamic effect and can reduce the dosage of each component separately, reducing the likelihood of side effects. The use of multicomponent hyperosmolar solutions can significantly reduce the total volume of fluid administered to patients.
 Conclusions. Complete hyperosmolar drugs can be recommended for routine and auxiliary fluid therapy and treatment for emergency conditions.