Abstract
Objectives. Using of systemic ozone therapy connecting with antioxidants in early period of burn disease for detoxication and metabolic disorders correction is investigated. Materials and Methods. We used active preventive metabolic detoxication in early period of burn disease (5th - 15th days after shock stage). It includes, besides complex infusion and transfusion therapy and classic pharmacological treatment, employment of antioxidants with succinic acid (reamberin, mexidol), systemic ozone therapy (intravenous injections of ozonated sodium chloride solution with ozone concentration 120 - 240 μg/mL; saturating ozone concentration in gas flow—5000 μg/L, sparging speed—2 l/min), major autohemotherapy (twice a week; ozone dose—250 - 300 μg/mL) and monitor cleansing of bowels with rectal ozone insufflations (ozone dose—1000 μg/mL). Estimation of personal oxidant dose and treatment effectiveness is carried out by biochemiluminescence control of pro- and antioxidant system state. Complex patient study also includes endotoxicosis markers (blood level of glucose, creatinine, bilirubin, urea and intermediate molecular weight peptides), proteolytic enzymes activity (tripsin, antitripsin, elastase), cardiovascular and microcirculation function examination (tetrapolar rheography, spirography, laser Doppler flowmetry) at burn disease dynamics. We formed two patients groups: first control group (20 burned patients) received a traditional therapy; second group (20 burned patients) got a described detoxication complex additional to treatment of first group. All patients had large burns (more than 20% body square). Indications for parenteral ozone therapy are signs of hypoxia (hypoxemia, elevated lactate level, depressed lactate dehydrogenase activity) and toxemia (increased blood level of glucose, creatinine, urea, intermediate molecular weight peptides, fibrine degradation products, lypoperoxidation intensification); cardiovascular dysfunction; respiratory function disorders. Results. Method of ozone dose individualization in intravenous ozone therapy and pharmacological treatment as oxidation stress correction is shown. This method is based on biochemiluminescence detection of patient blood antioxidant system reaction in ozonization in vitro. It is important that first stage of method is pro- and antioxidant potential estimation. Conclusions. It was shown that this algorithm use determines fully correction of oxygen homeostasis disorders and endotoxicosis. It optimizes results of complex treatment of burned patients.
Highlights
Burn disease is one of the main pathogenic factors in systemic inflammatory response syndrome (SIRS) and multiorganic insufficiency formation is endotoxicosis
We study oxygen active forms system using possibilities in urgent pathology, associated with hypoxia and toxemia, for oxygen homeostasis correction
This technology of individual selection of oxidative and antioxidant therapy was introduced in work of burn center of Nizhny Novgorod Research Institute of Traumatology and Orthopaedics [2]
Summary
Burn disease is one of the main pathogenic factors in systemic inflammatory response syndrome (SIRS) and multiorganic insufficiency formation is endotoxicosis Main substrates of this pathological process are tissue toxins and non-fully oxidized, hypoxia-associated metabolites. Menendes et al (2008) and others specialists [4, 5], are not effective, because at this disease oxygen homeostasis disorders are connected with oxidative stress, pro- and antioxidant disbalance, proteolysis, lypolysis and multiorganic dysfunction [3, 6, 7] It was shown early, that pro- and antioxidant balance is individual organism characteristic, determined by endogenic and exogenic factors summation [3, 8, 9]. This thesis determines ozone use with obligatory individual monitoring of pro- and antioxidant system state
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